Public health economics

Value of a statistical life, Quality adjusted life years…

2020-05-20 — 2025-06-07

Wherein the cost‑effectiveness of public health interventions is examined via QALY comparisons, an order‑of‑magnitude variation across modalities and age groups is reported, and COVID lockdown cost‑per‑QALY estimates are presented.

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Placeholder. Stuff I relied on during the COVID lockdowns that I’ve since been blessedly freed from.

Figure 1

1 Pollution

Fascinating. See health and chemistry.

2 QALY of interventions

Quality adjusted life years is how we measure many health outcomes, and is used to compare the cost-effectiveness of different interventions.

Analysis interventions we support in australia reveals an order-of-magnitude difference in cost-effectiveness between interventions, with some being very cost-effective and others not.

Dalziel, Segal, and Mortimer (2008) :

The median cost-effectiveness ratio was A$18,100 (~US$13,000) per QALY/DALY/LY (quality adjusted life year gained or, disability adjusted life year averted or life year gained). Some modalities tended to perform worse, such as vaccinations and diagnostics (median cost/QALY $58,000 and $68,000 respectively), than others such as allied health, lifestyle, in-patient interventions (median cost/QALY/DALY/LY all at A$9,000US$6,500). Interventions addressing some diseases such as diabetes and impaired glucose tolerance or alcohol and drug dependence tended to perform well (median cost/QALY/DALY/LY < A$3,700, < US$5,000). Interventions targeting younger persons < 25 years (median cost/QALY/DALY/LY < A$41,200) tended to perform less well than those targeting adults > 25 years (median cost/QALY/DALY/LY < A$16,000). However, there was also substantial variation in the cost effectiveness of individual interventions within and across all categories.

QALY-cost estimate of lockdown. Pretty high estimates IMO, but I agree the overall costs were high. I don’t know which Foster wrote it, but I wouldn’t be amazed if it was Gigi who was very emphatic about the issue when I last saw her at the pub.

3 Value of a statistical life lost

TBD.

4 Value of a statistical life gained

See natalism.

5 Contagious diseases

See epidemiology.

6 References

Altepeter. 2017. “The Effectiveness of Amish Home Remedies.”
Dalziel, Segal, and Mortimer. 2008. “Review of Australian Health Economic Evaluation – 245 Interventions: What Can We Say about Cost Effectiveness?” Cost Effectiveness and Resource Allocation : C/E.
Ferguson, Laydon, Nedjati Gilani, et al. 2020. “Report 9: Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID19 Mortality and Healthcare Demand.” Report.
Huang, Frijters, Dalziel, et al. 2018. “Life satisfaction, QALYs, and the monetary value of health.” Social Science & Medicine (1982).
Nickerson, and Solomon. 2020. “Car Seats as Contraception.” SSRN Electronic Journal.
Ormerod, and Wiltshire. 2009. “‘Binge’ Drinking in the UK: A Social Network Phenomenon.” Mind & Society.