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Related Experiment Videos

Discounting in decision making: the consistency argument revisited empirically.

Werner B F Brouwer1, N Job A van Exel

  • 1Department of Health Policy and Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. brouwer@bmg.eur.nl

Health Policy (Amsterdam, Netherlands)
|January 15, 2004
PubMed
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Societal decision-makers show inconsistency when evaluating present versus future health costs and effects. Their preferences are often influenced by problem framing, suggesting current discounting practices in health economics may need re-evaluation.

Area of Science:

  • Health Economics
  • Decision Science

Background:

  • Discounting costs and health effects is standard in economic evaluations.
  • Questions persist regarding the consistency and appropriateness of uniform discount rates (3-5%).
  • The Weinstein and Stason consistency argument frames ongoing debates.

Purpose of the Study:

  • To test the consistency of societal decision-makers' preferences for present versus future costs and health effects.
  • To determine if decision-makers discount costs and health effects at the same rate.
  • To explore alternative bases for discount rates, such as health endowment growth.

Main Methods:

  • Utilized hypothetical health care programs, similar to Weinstein and Stason's.
  • Assessed decision-makers' preferences regarding present and future costs and health outcomes.

Related Experiment Videos

  • Analyzed responses for consistency and discount rate application.

    • Main Results:

    • Decision-makers exhibited significant inconsistency in preferences for present versus future costs and health effects.
    • Respondents were susceptible to problem framing and displayed myopic tendencies.
    • Discount rates for health appeared linked to expectations of future life expectancy, varying by elicitation method.

    Conclusions:

    • Appointed decision-makers struggle to provide consistent preferences for discounting costs and health effects in economic evaluations.
    • Current discounting practices may not reflect stable or rational decision-making.
    • The growth rate of health endowment offers a potential alternative basis for discount rates, warranting further investigation.