Paul Dolan is Professor of Behavioural Science in the Department of Social Policy at the London School of Economics and Political Science and also serves as the Chief Academic Advisor on Economic Appraisal for the UK Government Economic Service. He has published extensively on what measures of benefit can and should to be used to inform resource allocation decisions in health care. His perspective is that the end-point of providing health care should not be health itself but, rather, the impact that health states have on overall subjective wellbeing, or “happiness”. This approach has important implications for how innovation and treatment are valued, challenging some of today’s most common methods.
In this new report published by the Office of Health Economics, Prof Dolan provides an accessible guide into the latest developments in happiness research as they apply to the valuation of health. This report considers the degree to which happiness data can overcome some of the well-known problems with existing preference-based ways of valuing health. It presents new valuation data that show how the dimensions of health that matter most in happiness regressions are not the same as those that matter most when people are asked about their preferences. In particular, mental health matters more in happiness reports. One implication of using happiness to value health, then, might be that greater priority would be given to mental wellbeing than to physical functioning and pain.
Download Dolan, P. (2011) Using happiness to value health. London: Office of Health Economics.
What a health care system should pay for depends, of course, on the health gain that results. Health technology assessment (HTA) and cost-effectiveness analysis have become the core for many such decisions — by NICE in the UK and by similar bodies elsewhere. Other factors, however, also are taken into account by the governments and insurers that fund health care. These typically include: the impact of decisions on social equity; the quality of the patient experience; ramifications for the wider economy; and the quality of evidence required for decision making. The purpose of this OHE monograph is to inform and stimulate debate about the way different sorts of evidence and considerations are taken into account in decisions about new health care technologies.