Valuing Health Outcomes: An Assessment of Approaches

Valuing Health Outcomes: An Assessment of Approaches
An RFF Conference
February 13-24, 2003

in partnership with

U.S. Environmental Protection Agency
U.S. Department of Agriculture
Occupational Safety & Health Administration
National Institutes of Health
Agency for Healthcare Research and Quality
Food and Drug Administration
U.S. Department of Transportation

Resources for the Future co-hosts a two-day conference on February 13-14, 2003 in Washington, DC to examine the conceptual and empirical bases for alternative health-benefit measures, the ways in which such measures are used and could be used in policymaking, and whether the choice of measure would actually make a difference in policy outcomes.

Bringing together a diverse group of experts, government officials, and stakeholders, the conference assesses the appropriate types and use of measures for valuing health outcomes of government activities. 

Conference Background and OMB Draft Report
Currently, government agencies are required under Executive Order 13258 to evaluate the costs and benefits of major regulations, defined as those expected to have a cost of at least $100 million dollars. The current interpretation of this directive is that agencies should provide estimates of economic benefits based on aggregations of individual willingness-to-pay (WTO), which reflects individual preferences for health and environmental improvements, and to compare them with the costs. Government agencies also evaluate non-regulatory activities. Practices here vary widely, including the use of cost-benefit and cost-effectiveness analysis, and for health benefits, the use of monetary valuation and other measures, such as Quality-Adjusted Life Years (QALYs).

The Office of Management and Budget, which reviews all regulations for compliance with E.O. 13258, has said it is considering the use of new effectiveness measures that combine information on mortality and morbidity, such as QALYs. 

OMB is considering such measures because

1. They allow for aggregation of mortality and morbidity without application of dollar values.

2. They provide more emphasis on morbidity impacts, and

3. QALYs have been widely adopted in the public health economics literature.