In or Out? Income Losses in Health State Valuations: A Review

Abstract

Seven empirical studies were identified. Overall, it seems that not explicitly mentioning the inclusion of income will induce a minority of respondents to include these effects and this appears not to influence results. More empirical work is needed, using generic instruments, larger samples, and using the interview method of administration.

Cuestiones controvertidas en evaluación económica (I): perspectiva y costes de intervenciones sanitarias

“…Queda claro que la discusión sobre los dos enfoques propuestos en la literatura está lejos de ser resuelta 11,[40][41][42] . Contar con dos métodos con hipótesis tan dispares, las cuales obviamente se reflejan en resultados muy distintos, supone un handicap para la puesta en prác-tica de evaluaciones económicas desde la perspectiva social.…”

Considering productivity loss in cost-effectiveness analysis: a new approach

“…Yet, income loss may be small in countries where paid sick leave schemes exist [10]. Furthermore, a recent review on empirical evidence for the consideration of income loss in direct preference-based measures in the United States and other countries concluded that ''not explicitly mentioning the inclusion of income will induce a minority of respondents to include these effects and this appears not to influence results'' [10]. A very recent large-sample survey in the general population of Japan confirmed this finding.…”

A further examination of the problem of double-counting in incremental cost-utility analyses

“…A systematic review found that in the absence of instructions, only a minority of respondents actually consider income loss in health state valuations [1]. The purpose of this editorial is to reexamine the valuation of productivity loss and consider the potential for double-counting in a net health benefit framework.…”

“…The debate regarding the inclusion of productivity costs (PCs) in cost-utility analyses (CUA) continues [1,2]. The concern is that PCs included in the numerator of an incremental costutility ratio (ICUR) may cause double-counting if the productivity loss is also incorporated in health state valuation.…”

“…Using Tilling's example [1], a healthy 45-year-old patient, earning an annual wage of £30,000 (including benefits), will have 20 years of LE over a time horizon extending until retirement (age 65). If this patient suffers a disability that results in death after 10 years, then under standard care conditions TC (S) = PC(S) = £30,000 × (20-10) = £300,000.…”