The value of a statistical life-year in sub-Saharan Africa

• Verfasst von: Patenaude, Bryan N. [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Titel: The value of a statistical life-year in sub-Saharan Africa
• Titelzusatz: evidence from a large population-based survey in Tanzania
• Verf.angabe: Bryan N. Patenaude, Innocent Semali, Japhet Killewo, Till Bärnighausen
• E-Jahr: 2019
• Jahr: 5 September 2019
• Umfang: 6 S.
• Fussnoten: Gesehen am 06.04.2020
• Titel Quelle: Enthalten in: Value in health regional issues
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 2012
• Jahr Quelle: 2019
• Band/Heft Quelle: 19(2019), Seite 151-156
• ISSN Quelle: 2212-1102
• DOI: doi:10.1016/j.vhri.2019.07.009
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cost-effectiveness
• Sach-SW: economic evaluation
• Sach-SW: health policy
• Sach-SW: public health
• Sach-SW: stated preference
• K10plus-PPN: 169411211X

Abstract

Background - The value of a statistical life-year (VSLY) is the central number for the economic allocation of health resources. Nevertheless, empirical data on VSLY are lacking for most low- and middle- income countries. In the absence of empirically established VSLY, researchers typically use an arbitrary 3-times multiple of per-capita gross domestic product or per-capita income per life-year saved to establish cost-effectiveness. - Objective - In this study, we establish an empirical VSLY for the first time for a community in sub-Saharan Africa. - Methods - To empirically establish VSLY, we randomly selected 4000 individuals in the Ukonga community of Tanzania and employed a contingent valuation survey to measure VSLY. Using the contingent valuation methodology, we elicited willingness to pay for a 2% mortality risk reduction and had individuals convert this into an annualized payment to be paid each year over their expected remaining life. - Results - We compared our elicited value to per-capita income and found that mean VSLY is $9340 (95% CI $6206-$12 373). The mean annual income in our sample was $2069, resulting in a VSLY that is equivalent to 4.5 times per-capita income. - Conclusion - Our results provide empirical evidence to support moving away from using the World Health Organization cost-effectiveness thresholds in practice because they will likely result in inefficient underinvestment in cost-effective interventions, even in relatively poor samples.