Accounting for planetary boundaries in health economic evaluation

Area of Science:

• Environmental Health
• Health Economics
• Life Cycle Assessment

Background:

• Health economic evaluation (HEE) traditionally overlooks ecological scarcities when environmental costs are external.
• This limitation hinders comprehensive decision-making, particularly concerning planetary health.
• Integrating ecological considerations is crucial for sustainable resource allocation.

Purpose of the Study:

• To explore methods for addressing the blind spot in HEE regarding ecological scarcities.
• To enhance HEE by incorporating planetary health imperatives.
• To bridge the gap between economic evaluation and environmental impact assessment.

Main Methods:

• Critical review of Health Economic Evaluation (HEE) and Life Cycle Assessment (LCA) literature.
• Examining LCA's capacity to inform both effect and cost sides of HEE.
• Investigating the use of shadow prices and disaggregated environmental impact reporting.

Main Results:

• Life Cycle Assessment (LCA) data can quantify environmental impacts for HEE.
• Environmental impacts can be integrated into cost-benefit and cost-utility analyses.
• Shadow prices and disaggregated data facilitate incorporating ecological costs into HEE.

Conclusions:

• Accounting for planetary boundaries represents a significant methodological innovation for HEE.
• This integration is vital for aligning economic decisions with environmental sustainability.
• HEE incorporating ecological impacts will improve decision-making for technologies with similar cost-effectiveness but differing environmental footprints.