{"title":"Coronavirus and the Economic Value of Human Life","authors":"J. Jessop","doi":"10.2139/ssrn.3851974","DOIUrl":"https://doi.org/10.2139/ssrn.3851974","url":null,"abstract":"COVID-19 has revealed familiar problems in health economics and cost-benefit analysis and the \"tragic choices\" that sometimes must be made. Policymakers frequently have to attach a monetary value to a human life based on the number of years that a person might have left to live and that life's quality (the concept behind \"QALYs\"). It is reasonable to acknowledge that the mortality rates for those with Covid-19 are higher for elderly people and those with pre-existing health problems. It is also important to recognise the \"identifiable victim\" problem, which may lead policymakers to focus too much on those at risk of dying from COVID-19 and not enough on less visible costs. While there may be a risk of over-estimating the economic and fiscal costs of the lockdown itself, as the economy was already weakening before the lockdown began and many people were changing their behaviour without state direction, there is ample evidence that the lockdown has compounded the economic hit. This recession is unprecedented. GDP will have fallen by a relatively large amount in a relatively short period of time. But the economy could still rebound quickly, as the threat recedes. A temporary pause would be less costly than a prolonged slump. However, the longer the lockdown remains in place, the greater the margin by which the costs are likely to outweigh the benefits and risk to make the damage permament. It may still be right to focus on the impact on health, rather than any short-term economic costs. Yet the balance is shifting even on this score, given that patients are not getting treated for other conditions and younger people who are missing out on education and job opportunities.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132848482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pricing for Survival in the Biopharma Industry: A Case Study of Acthar Gel and Questcor Pharmaceuticals","authors":"T. Burnham, Samuel Huang, A. Lo","doi":"10.2139/ssrn.3040369","DOIUrl":"https://doi.org/10.2139/ssrn.3040369","url":null,"abstract":"Recent cases of aggressive pricing behavior in the biopharmaceutical industry have raised serious concerns among payers and policymakers about industry ethics. However, these cases should not be confused with price increases motivated by challenging business conditions that ultimately lead to greater investment in R&D and improved patient access to therapeutics. We study the example of Questcor Pharmaceuticals, which was forced to choose between increasing the price of an effective drug in 2007 and ceasing production and shutting down. We consider Questcor’s journey from inception to its acquisition in 2014, analyze the factors leading up to the price hike of its main revenue generator, Acthar Gel, and discuss its resulting impact on patients after 2007. A counterfactual financial simulation of the company’s prospects in the case where prices were not increased shows that Questcor would have become insolvent between 2008–2010.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125982497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Judy C. Xu, Shiyong Liu, Gordon Liu, D. Bishai, H. Xue, Youfa Wang
{"title":"Integration of Patients' Decision-Making in Cost-Effectiveness Analysis of Diabetes Interventions: A Simulation Study Using System Dynamics Modeling","authors":"Judy C. Xu, Shiyong Liu, Gordon Liu, D. Bishai, H. Xue, Youfa Wang","doi":"10.2139/ssrn.2841500","DOIUrl":"https://doi.org/10.2139/ssrn.2841500","url":null,"abstract":"Markov-based and discrete event simulation models are widely used in health economic analysis to estimate the long term effects of treatment on clinical and economic outcomes. However, none of them simultaneously integrate patients’ economic resources and their medical decision making in the simulation. This study applied systems dynamics modeling into cost-effectiveness analysis (CEA) of glycemic control treatment. It explored the nonlinear dynamic impacts of patients’ behavior on the cost effectiveness of different interventions to better understand the complexity of diabetes patients’ medical choices in the real world and their impacts on the clinical and economic consequences.Our results showed that the cost-effectiveness ratio varied with patients’ out-of-pocket payment threshold for health care. It suggests that patients’ decision making of cost-related non-adherence with medication should be considered while conducting CEA for treatment of complex chronic condition like diabetes.This study offers insight into the current dynamics of health care costs and outcomes. While providing a framework for CEA with integration of diabetes treatment adherence, it opens up ways of evaluate the complexity of health care for chronic condition in the real world.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117050199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Smoking and Other Economic Variables on Wages in the Euro Area","authors":"E. Bondzie","doi":"10.2139/ssrn.2727228","DOIUrl":"https://doi.org/10.2139/ssrn.2727228","url":null,"abstract":"The smoking effects on wages has been examined in this work using different econometric methodologies with the use of European Community Household Panel (ECHP) datasets. We employ econometric tools like Instrumental Variable technique, Heckman correction factor, Endogenous Switching and matching estimates. The initial results from regression estimates (OLS and IV methods) revealed that the wage gap between smokers and non-smokers ranges 1% to 22.7%. Moreover, endogenous switching and matching estimator also showed a negative average treatment effect of approximately 47% and 4.3% to 6.9% respectively. Thus smokers observed less wage effects is explained in part by real effects on their health status and a measure of unobserved preferences.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122225545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Conjoint Analysis of Micro-Health Insurance Programmes in Bangladesh","authors":"M. Howlader","doi":"10.2139/ssrn.2560850","DOIUrl":"https://doi.org/10.2139/ssrn.2560850","url":null,"abstract":"This study scrutinizes conjoint analysis of Micro Health Insurance Programme (MHIP) and determines utility value of MHIPs’ attributes from consumer’s point of view. It has used two-stage model to observe this matter. First, it finds out the factors, which affect the MHIPs’ QALY values and secondly determine utility values using conjoint technique of Part-Worth model. The findings of the study indicate that important determinants producing highest utility values which are prescription coverage, doctor qualification, maternal and child health coverage, and service provider quality. The less important attributes gain less utility values that are vision coverage, hospitalization coverage, physical examination, well baby visit and immunization It also reveals that the over-all health status of rural based MHIP participants is lower as compared to the urban based MHIP counterparts.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126496320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Garau, K. Shah, A. Mason, Qing Wang, A. Towse, M. Drummond
{"title":"Using QALYs in Cancer: A Review of the Methdological Limitations","authors":"M. Garau, K. Shah, A. Mason, Qing Wang, A. Towse, M. Drummond","doi":"10.2139/ssrn.2634461","DOIUrl":"https://doi.org/10.2139/ssrn.2634461","url":null,"abstract":"The objective of this paper is to examine how well the QALY captures the health gains generated by cancer treatments, with particular focus on the methods for constructing QALYs preferred by the UK National Institute for Health and Clinical Excellence (NICE). Data were obtained using a keyword search of the MEDLINE database and a hand search of articles written by leading researchers in the subject area (with follow up of the references in these articles). Key arguments were discussed and developed at an oncology workshop in September 2009 at the Office of Health Economics. Three key issues emerged. First, the EQ-5D, NICE's preferred measure of health-related quality of life (QOL) in adults, has been found to be relatively insensitive to changes in health status of cancer patients. Second, the time trade-off, NICE's preferred technique for estimating the values of health states, involves making assumptions that are likely to be violated in end-of-life scenarios. Third, the practice of using valuations of members of the general population, as recommended by NICE, is problematic because such individuals typically display a misunderstanding of what it is really like for patients to live with cancer. Because of the way in which it is constructed, the QALY shows important limitations in terms of its ability to accurately capture the value of the health gains deemed important by cancer patients. A research agenda for addressing these limitations is proposed.","PeriodicalId":201568,"journal":{"name":"HEN: Valuation: Life","volume":"435 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126103983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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