Fairness in Cost-Benefit Analysis: An Application to Health Technology Assessment

49 Pages Posted: 16 Nov 2015

See all articles by Anne-Laure Samson

Anne-Laure Samson

Université Paris Ouest - Nanterre, La Défense - EconomiX

Erik Schokkaert

Catholic University of Leuven (KUL)

Clémence Thébaut

Independent

Brigitte Dormont

Université Paris Dauphine

Marc Fleurbaey

Princeton University - Woodrow Wilson School of Public and International Affairs

Stéphane Luchini

Université Paul Cézanne Aix Marseille, EHESS

Carine Van de Voorde

Catholic University of Leuven (KULeuven)

Date Written: November 10, 2015

Abstract

We evaluate the introduction of various forms of antihypertensive treatment in France with a distribution-sensitive cost-benefit analysis. Compared to traditional cost-benefit analysis, we implement distributional weighting based on equivalent incomes, a new concept of individual well-being that does respect individual preferences but is not subjectively welfarist. Individual preferences are estimated on the basis of a contingent valuation question, introduced into a representative survey of the French population. Compared to traditional cost-effectiveness analysis in health technology assessment, we show that it is practically feasible to go beyond a narrow evaluation of health outcomes while still fully exploiting the technical sophistication of medical information. Sensitivity analysis illustrates the relevancy of this richer welfare framework, the importance of the distinction between an ex ante and an ex post-approach, and the need to consider distributional effects in a broader institutional setting.

Suggested Citation

Samson, Anne-Laure and Schokkaert, Erik and Thébaut, Clémence and Dormont, Brigitte and Fleurbaey, Marc and Luchini, Stéphane and Van de Voorde, Carine, Fairness in Cost-Benefit Analysis: An Application to Health Technology Assessment (November 10, 2015). Available at SSRN: https://ssrn.com/abstract=2691290 or http://dx.doi.org/10.2139/ssrn.2691290

Anne-Laure Samson (Contact Author)

Université Paris Ouest - Nanterre, La Défense - EconomiX ( email )

200 Avenue de la République
Nanterre cedex, Nanterre Cedex 92000
France

Erik Schokkaert

Catholic University of Leuven (KUL) ( email )

Oude Markt 13
Leuven, Vlaams-Brabant 3000
Belgium

Clémence Thébaut

Independent ( email )

No Address Available

Brigitte Dormont

Université Paris Dauphine ( email )

Place du Marechal de Lattre de Tassigny
75016 Paris, 75775
France

Marc Fleurbaey

Princeton University - Woodrow Wilson School of Public and International Affairs ( email )

Princeton University
Princeton, NJ 08544-1021
United States

Stéphane Luchini

Université Paul Cézanne Aix Marseille, EHESS ( email )

3, Avenue Robert Schuman
Aix-en-Provence Cedex 1, Aix en Provence 13628
France

Carine Van de Voorde

Catholic University of Leuven (KULeuven) ( email )

Naamsestraat 69
B-3000 Leuven, 3000
Belgium

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