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Reading: What should NICE's Discount Rate on Future Health-Related Well-Being Be?

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What should NICE's Discount Rate on Future Health-Related Well-Being Be?

Author:

Rob Pepper

Abstract

I argue that the National Institute for Heath and Care Excellence (NICE) should use a lower discount rate on future health-related well-being1 than its current 3.5% rate. A positive discount rate, applied to cost-effectiveness analysis (CEA), means the value of a given unit of health is considered greater the closer to the present it is realised. I recognise the discount rate should be higher than 0% because of uncertainty about the future and the instrumental benefits of earlier investment in health. Nonetheless, the current discount rate leads NICE to implausibly value healthcare interventions that treat existing conditions at dramatically higher levels than interventions that prevent future conditions. Though I do not specify what the actual discount rate should be, I argue that a rate lower than 3.5% would enable NICE to make more defensible trade-offs between present and future health.
How to Cite: Pepper, R., 2019. What should NICE's Discount Rate on Future Health-Related Well-Being Be?. Rerum Causae, 11(1), pp.1–18.
Published on 19 Sep 2019.
Peer Reviewed

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