School of Business, Örebro University, SE-701 82, Örebro, Sweden.
Eur J Health Econ. 2021 Apr;22(3):357-363. doi: 10.1007/s10198-020-01257-x. Epub 2021 Feb 22.
Results from economic evaluations of long-term outcomes are strongly dependent on the chosen discount rate. A recent review of national guidelines for evaluation of healthcare interventions finds that "the level of currently used discount rates seems relatively high in many countries". However, this conclusion comes from a comparison to rates derived or observed for investments in safe assets, while rate of return requirements are typically considerably higher when investment involves risk. This paper reviews recent literature on how to account for project-specific risk in determination of the social rate of discount and discusses implications for economic evaluation of healthcare interventions. It concludes that the available empirical evidence strongly suggests that the demand for and consumer value of health and healthcare is co-variant with income, which therefore implies that there is a non-diversifiable risk component of health-related investment.
结果从长期结果的经济评估强烈依赖于所选择的折扣率。最近对国家医疗保健干预措施评估指南的审查发现，“目前使用的折扣率水平在许多国家似乎相对较高”。然而，这一结论来自于与安全资产投资中得出或观察到的利率的比较，而当投资涉及风险时，回报率要求通常要高得多。本文回顾了最近关于如何在确定社会折现率时考虑项目特定风险的文献，并讨论了其对医疗保健干预经济评估的影响。它的结论是，现有经验证据强烈表明，对健康和医疗保健的需求和消费者价值与收入是相关的，因此这意味着与健康相关的投资存在不可分散的风险成分。
