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减小寿命边际效用对估值股权在成本效益分析中的影响
1Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
MDM policy & practice
|January 22, 2025
概括
减少边际寿命效用 (DMLU) 表明寿命增长在年龄较大时的价值较低. 将DMLU纳入成本效益分析对于公平的健康结果评估至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
- 公共卫生政策 公共卫生政策
背景情况:
- 递减边际寿命效用 (DMLU) 假定,随着总寿命的增加,额外的一年生命的价值会下降.
- 由于区分它与折扣和风险态度的复杂性,DMLU的特征很差.
- 在成本效益分析 (CEA) 中,越来越重视公平性,因此需要更清楚地理解DMLU.
研究的目的:
- 通过综合现有文献和使用一个说明性的例子来描述DMLU.
- 评估DMLU在健康公平和CEA的背景下的相关性和影响.
主要方法:
- 关于实用曲率的声明偏好研究的文献综述,不包括风险和概率.
- 一个说明性的例子,比较对干预措施的评估,以减少囊性纤维化,有或没有DMLU的健康结果差异.
主要成果:
- 经验证据表明,在典型的CEA时间范围内,DMLU可能是相关的.
- 在以公平为重点的CEA中,DMLU的重要性得到了放大,特别是在代际分析和使用不平等厌恶措施时.
- 如果不考虑DMLU,则可以在基于寿命年度量的指标中引入反股权偏差.
结论:
- DMLU很可能存在,因此值得进一步描述,并与折扣一起在CEA中包含.
- 省略DMLU可能会导致反股权偏见,并影响包含不平等厌恶的CEA的解释.
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