The Value of a Statistical Life-Year in Sub-Saharan Africa: Evidence From a Large Population-Based Survey in Tanzania

Patenaude, Bryan; Semali, Innocent; Killewo, Japhet; Bärnighausen, Till

doi:10.1016/j.vhri.2019.07.009

Cited by 16 publications

(30 citation statements)

References 22 publications

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“…The flow diagram for study selection is shown in Figure 1. A total of 45 (84.9%) studies 14,[21][22][23][24] used the direct approach, whereas 8 (15.1%) studies 25,[71][72][73][74][75][76][77] used the indirect approach (see Appendix Tables 5 and 6 in Supplemental Materials found at https://doi.org/10.1 016/j.jval.2021.05.018).…”

Section: Resultsmentioning

confidence: 99%

“…Despite the wide range of values, almost half (46.7%) of the studies using the direct approach reported estimates that were less than GDP per capita. 14,23,32,38,40,[42][43][44][48][49][50]56,[59][60][61]63,[66][67][68][69][70] Most (62.5%) studies using the indirect approach converted VSL estimates to monetary values of a QALY, while one 71 38), which corresponded to a median ratio (range) of 7.87 (0.68-116.95) GDP per capita. Notably, in contrast with results using the direct approach, indirect studies reported estimates that were within the range of 1 to 3 times GDP per capita (37.5%) or greater than 3 times the GDP per capita (37.5%).…”

Section: Estimates Of Monetary Value For Health Gainmentioning

confidence: 99%

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A Systematic Review of Demand-Side Methods of Estimating the Societal Monetary Value of Health Gain

et al. 2021

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Objectives: Although many reviews of the literature on cost-effectiveness thresholds (CETs) exist, the availability of new studies and the absence of a fully comprehensive analysis warrant a new review. This study systematically reviews demand-side methods for estimating the societal monetary value of health gain.Methods: Several electronic databases were searched from inception to October 2019. To be included, a study had to be an original article in any language, with a clearly described method for estimating the societal monetary values of health gain and with all estimated values reported. Estimates were converted to US dollars ($), using purchasing power parity (PPP) exchange rates and the gross domestic product (GDP) per capita (2019).Results: We included 53 studies; 45 used direct approach and 8 used indirect approach. Median estimates from the direct approach were PPP$ 24 942 (range 554-1 301 912) per quality-adjusted life-year (QALY), which were typically 0.53 (range 0.02-24.08) GDP per capita. Median estimates using the indirect approach were PPP$ 310 051 (range 36 402-7 574 870) per QALY, which accounted for 7.87 (range 0.68-116.95) GDP per capita.Conclusions: Our review found that the societal values of health gain or CETs were less than GDP per capita. The great variety in methods and estimates suggests that a more standardized and internationally agreed methodology for estimating CET is warranted. Multiple CETs may have a role when QALYs are not equally valued from a societal perspective (eg, QALYs accruing to people near death compared with equivalent QALYs to others).

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Section: Resultsmentioning

confidence: 99%

Section: Estimates Of Monetary Value For Health Gainmentioning

confidence: 99%

A Systematic Review of Demand-Side Methods of Estimating the Societal Monetary Value of Health Gain

et al. 2021

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“…VSL is a fixed number that embodies the aggregate dollar amount the population are collectively willing to pay to reduce the mortality risk regardless of age [22]. The underlying assumption is that all lives are equally valued from the societal perspective [12].…”

Section: Estimation Processmentioning

confidence: 99%

Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life

et al. 2021

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Cost-effective threshold (CET) is essential for health technology assessment and decision-making based on health economic evaluations. Recently, it has been argued that the commonly used once and three times of gross domestic product (GDP) per capita CETs of a quality-adjusted life year (QALY) are not necessarily empirically supported in all countries. Therefore, we aimed to estimate the CET of a QALY as times of GDP per capita in China, of which the reimbursement coverage decisions are increasingly engaging economic evaluations. Estimates on the value of statistical life (VSL) in China were identified from several studies in the literature and converted to times of GDP per capita, the weighted average of which was used for subsequent calculation. By pooling data on population mortality, health utility, and age distribution, we estimated the value of a statistical QALY (VSQ) from VSL using an established mathematical process, which represented the theoretical upper bound of CET. The corresponding point estimate and theoretical lower bound were obtained using their numerical relationships with the upper bound. Scenarios analyses were also conducted. The estimated CET, its upper bound, and its lower bound were 1.45, 2.90, and 1.16 times of GDP per capita in China, respectively. In different scenarios, the estimated CET varied but was greater than once GDP per capita in most cases. As such, the CET of a QALY in China is close to 1.5 times of GDP per capita, which should be benchmarked for future ICER-based coverage decisions.

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“…This estimate is approximately 4·4 times per-capita GDP in 2020 ($8429), which is in agreement with empirically measured values for sub-Saharan Africa (4·5 times the per-capita GDP). 43 However, empirically established values of a statistical life are also now less reliable because the mean social valuation of mortality risk reduction is likely to be influenced by the emergence of the COVID-19 global pandemic. Our estimates also do not reflect losses due to deaths in individuals who received treatment for tuberculosis and then recovered.…”

Section: Discussionmentioning

confidence: 99%

Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis

Silva

Arinaminpathy

Atun

et al. 2021

The Lancet Global Health

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Background The tuberculosis targets for the UN Sustainable Development Goals (SDGs) call for a 90% reduction in tuberculosis deaths by 2030, compared with 2015, but meeting this target now seems highly improbable. To assess the economic impact of not meeting the target until 2045, we estimated full-income losses in 120 countries, including those due to excess deaths resulting from COVID-19-related disruptions to tuberculosis services, for the period 2020–50. Methods Annual mortality risk changes at each age in each year from 2020 to 2050 were estimated for 120 countries. This risk change was then converted to full-income risk by calculating a population-level mortality risk change and multiplying it by the value of a statistical life-year in each country and year. As a comparator, we assumed that current rates of tuberculosis continue to decline through the period of analysis. We calculated the full-income losses, and mean life expectancy losses per person, at birth and at age 35 years, under scenarios in which the SDG targets are met in 2030 and in 2045. We defined the cost of inaction as the difference in full-income losses and tuberculosis mortality between these two scenarios. Findings From 2020 to 2050, based on the current annual decrease in tuberculosis deaths of 2%, 31·8 million tuberculosis deaths (95% uncertainty interval 25·2 million–39·5 million) are estimated to occur, corresponding to an economic loss of US$17·5 trillion (14·9 trillion–20·4 trillion). If the SDG tuberculosis mortality target is met in 2030, 23·8 million tuberculosis deaths (18·9 million–29·5 million) and $13·1 trillion (11·2 trillion–15·3 trillion) in economic losses can be avoided. If the target is met in 2045, 18·1 million tuberculosis deaths (14·3 million–22·4 million) and $10·2 trillion (8·7 trillion–11·8 trillion) can be avoided. The cost of inaction of not meeting the SDG tuberculosis mortality target until 2045 ( vs 2030) is, therefore, 5·7 million tuberculosis deaths (5·1 million–8·1 million) and $3·0 trillion (2·5 trillion–3·5 trillion) in economic losses. COVID-19-related disruptions add $290·3 billion (260·2 billion–570·1 billion) to this cost. Interpretation Failure to achieve the SDG tuberculosis mortality target by 2030 will lead to profound economic and health losses. The effects of delay will be greatest in sub-Saharan Africa. Affected countries, donor nations, and the private sector should redouble efforts to finance tuberculosis programmes and research because the economic dividend of such strategies is likely to be substantial. Funding None.

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The Value of a Statistical Life-Year in Sub-Saharan Africa: Evidence From a Large Population-Based Survey in Tanzania

Cited by 16 publications

References 22 publications

A Systematic Review of Demand-Side Methods of Estimating the Societal Monetary Value of Health Gain

A Systematic Review of Demand-Side Methods of Estimating the Societal Monetary Value of Health Gain

Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life

Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis

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