Estimating implied rates of discount in healthcare decision-making

Abstract

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Lump Sum Alternatives to Current Veterans' Disability Compensation

“…The total savings realized by VA would depend on the difference between the lump sum and the present value of the lifetime payments, as well as on the proportion of veterans tak- 14. In an analysis of the effect of a lump sum program on compensation costs, the authors note that "expanding the array of choice options before an individual can never make that person worse off" [2].…”

“…Estimates of personal discount rates vary widely from study to study [14]. For example, experimental studies (looking at hypothetical choices involving small amounts) estimate personal discount rates to be between 20 and 38 percent [15,16,17,18].…”

“…Similarly, discount rates tend to be lower when individuals are making choices over longer time periods [14,22,23]. Warner and Pleeter [23] found that discount rates depend on the size of the lump sum.…”

“…14 In other words, offering a lump sum would necessarily make veterans at least as satisfied as without that offer because they would still be able to decline the lump sum in favor of receiving compensation in monthly payments just as they currently do. A third advantage for veterans would be reduced administrative interactions.…”

Effect of discounting on estimation of benefits determined by hepatitis C treatment

“…The discount rate is the typical method employed in cost-effectiveness studies to convert future clinical benefits into their present value [9][10][11][12][13][14] . In the United States, rates around 5% or 6% per year were suggested nearly 20 years ago, but later various panels of experts revised this suggestion by proposing an annual rate of 3% [9,10] .…”