Author:

Keywords:

Social Sciences, Science & Technology, Life Sciences & Biomedicine, Economics, Health Care Sciences & Services, Health Policy & Services, Business & Economics, antihypertensive treatment, cost-benefit analysis, distributional weights, equivalent income, TIME TRADE-OFF, MATTERS, Adult, Cost-Benefit Analysis, Female, France, Health Status, Humans, Hypertension, Income, Male, Middle Aged, Social Welfare, Surveys and Questionnaires, Technology Assessment, Biomedical, 1117 Public Health and Health Services, 1402 Applied Economics, 1403 Econometrics, 3801 Applied economics, 4407 Policy and administration

Abstract:

We evaluate the introduction of various forms of antihypertensive treatments in France with a distribution-sensitive cost-benefit analysis. Compared to traditional cost-benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well-being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population. Compared to traditional cost-effectiveness analysis in health technology assessment, we show that it is feasible to go beyond a narrow evaluation of health outcomes while still fully exploiting the sophistication of medical information. Sensitivity analysis illustrates the relevancy of this richer welfare framework, the importance of the distinction between an ex ante and an ex post approach, and the need to consider distributional effects in a broader institutional setting.