Accounting for Future Health Events: Including future costs and valuing health gains in health care decision-making

In her thesis, Meg Perry-Duxbury MSc investigates how several future health events, in terms of costs and benefits, can be accounted for in the context of health care decision-making, from both a health care perspective and a societal perspective.

More efficient use of health care resources

Perry-Duxbury started her thesis with an investigation into the standardisation of including so-called future unrelated medical costs and future non-medical costs in economic evaluation and in the cost-effectiveness threshold. These costs are effectively the costs generated when a medical treatment extends life years. The findings in this thesis strengthen the argument that accounting for future health events in health care decision-making leads to a more efficient use of health care resources. Furthermore, the tools developed from this thesis help standardise the inclusion of future costs in models and dossiers being submitted to health care authorities (such as Zorginstituut Nederland).

The second part of Perry-Duxbury’s research covered methods that may be used when eliciting the value of safety and estimated the value of quality-adjusted life year (QALY) gains, potentially including this value of safety, in the context of an early warning system for infectious disease outbreaks (such as COVID-19).

Value of public health interventions

This thesis finds that when valuing a prevention programme, feelings of safety are worth incorporating. This is because even if an early warning system is never utilised, individuals’ wellbeing may be improved by the feeling of safety generated by the existence of such a system. A conclusion from this research is that if we can better understand the value of public health interventions that contain and mitigate disease outbreaks, the more optimal our policy responses can be when significant global events (such as a pandemic) occur.