Estimating the monetary value of health and capability well-being applying the well-being valuation approach

Eur J Health Econ. 2020 Nov;21(8):1235-1244. doi: 10.1007/s10198-020-01231-7. Epub 2020 Sep 16.

Abstract

Background: Quality of life measures going beyond health, like the ICECAP-A, are gaining importance in health technology assessment. The assessment of the monetary value of gains in this broader quality of life is needed to use these measurements in a cost-effectiveness framework.

Methods: We applied the well-being valuation approach to calculate a first monetary value for capability well-being in comparison to health, derived by ICECAP-A and EQ-5D-5L, respectively. Data from an online survey administered in February 2018 to a representative sample of UK citizens aged 18-65 was used (N = 1512). To overcome the endogeneity of income, we applied an instrumental variable regression. Several alternative model specifications were calculated to test the robustness of the results.

Results: The base case empirical estimate for the implied monetary value of a year in full capability well-being was £66,597. The estimate of the monetary value of a QALY, obtained from the same sample and using the same methodology amounted to £30,786, which compares well to previous estimates from the willingness to pay literature. Throughout the conducted robustness checks, the value of capability well-being was found to be between 1.7 and 2.6 times larger than the value of health.

Conclusion: While the applied approach is not without limitations, the generated insights, especially concerning the relative magnitude of valuations, may be useful for decision-makers having to decide based on economic evaluations using the ICECAP-A measure or, to a lesser extent, other (capability) well-being outcome measures.

Keywords: Capability approach; Economic evaluation; Subjective well-being; Value of health; Well-being valuation.

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Quality of Life*
  • Surveys and Questionnaires