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Estimating the marginal cost of a life year in Sweden's public healthcare sector
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-4853-5576
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0003-1699-3185
2019 (English)In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 20, no 5, p. 751-762Article in journal (Refereed) Published
Abstract [en]

Although cost-effectiveness analysis has a long tradition of supporting healthcare decision-making in Sweden, there are no clear criteria for when an intervention is considered too expensive. In particular, the opportunity cost of healthcare resource use in terms of health forgone has not been investigated empirically. In this work, we therefore seek to estimate the marginal cost of a life year in Sweden's public healthcare sector using time series and panel data at the national and regional levels, respectively. We find that estimation using time series is unfeasible due to reversed causality. However, through panel instrumental variable estimation we are able to derive a marginal cost per life year of about SEK 370,000 (EUR 39,000). Although this estimate is in line with emerging evidence from other healthcare systems, it is associated with uncertainty, primarily due to the inherent difficulties of causal inference using aggregate observational data. The implications of these difficulties and related methodological issues are discussed.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 20, no 5, p. 751-762
Keywords [en]
Cost-effectiveness analysis, Healthcare expenditure, Life expectancy, Mortality, Opportunity cost, Threshold
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Economics
Identifiers
URN: urn:nbn:se:liu:diva-155512DOI: 10.1007/s10198-019-01039-0ISI: 000474490700011PubMedID: 30796552Scopus ID: 2-s2.0-85062020116OAI: oai:DiVA.org:liu-155512DiVA, id: diva2:1297668
Note

Funding agencies:  Region ostergotland

Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-08-22Bibliographically approved

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Siverskog, JonathanHenriksson, Martin

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Health Care Service and Management, Health Policy and Services and Health EconomyEconomics

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Citation style
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