Bala M V, Mauskopf J A, Wood L L
Outcomes Research, Centocor, Inc., Malvern, Pennsylvania, USA.
Pharmacoeconomics. 1999 Jan;15(1):9-18. doi: 10.2165/00019053-199915010-00002.
In this paper, we discuss the use of cost-benefit analysis (CBA) for evaluating new healthcare interventions, present the theoretical basis for the use of willingness to pay as a method for valuing benefits in a CBA and describe how to obtain willingness-to-pay (WTP) measures of health benefits and how to use these values in a CBA. We review selected economic studies on consumer demand and consumer surplus and studies presenting WTP estimates for healthcare interventions. The theoretical foundations of willingness to pay as a measure of commodity value are rooted in consumer demand theory. The area under the fixed income consumer demand curve represents the consumer's maximum willingness to pay for the commodity. We identify 3 types of potential benefits from a new healthcare intervention, namely patient benefits, option value and altruistic value, and suggest WTP questions for valuing different combinations of these benefits. We demonstrate how responses to these questions can be adjusted for income effects and incorporated into economic evaluations. We suggest that the lack of popularity of CBAs in the health area is related to the perceived difficulty in valuing health benefits as well as concern over how CBA incorporates the distribution of income. We show that health benefits can be valued using simple survey techniques and that these values can be adjusted to any desired income distribution.
在本文中，我们讨论了使用成本效益分析（CBA）来评估新的医疗保健干预措施，阐述了将支付意愿作为CBA中衡量效益的一种方法的理论基础，并描述了如何获得健康效益的支付意愿（WTP）度量以及如何在CBA中使用这些值。我们回顾了关于消费者需求和消费者剩余的部分经济研究，以及给出医疗保健干预措施WTP估计值的研究。支付意愿作为商品价值度量的理论基础源于消费者需求理论。固定收入消费者需求曲线下方的区域代表消费者对该商品的最大支付意愿。我们确定了新的医疗保健干预措施的3种潜在效益，即患者效益、期权价值和利他价值，并针对这些效益的不同组合提出了用于估值的WTP问题。我们展示了如何针对收入效应调整对这些问题的回答，并将其纳入经济评估。我们认为CBA在卫生领域缺乏普及性与人们认为难以对健康效益进行估值以及对CBA如何纳入收入分配的担忧有关。我们表明，可以使用简单的调查技术对健康效益进行估值，并且这些值可以根据任何期望的收入分配进行调整。
