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Scott D. Ramsey, How Should We Value Lives Lost to Cancer?, JNCI: Journal of the National Cancer Institute, Volume 100, Issue 24, 17 December 2008, Pages 1742–1743, https://doi.org/10.1093/jnci/djn434
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To be trained in medicine, nursing or one of the other “sharp end” disciplines and then be faced with some hard-nosed, cold-blooded economist placing money values on human life and suffering is an anathema to many (1).
Cancer is one of the most feared of all diseases. The toll it takes on society in terms of suffering and early mortality is well known. Why then should we try to place a dollar value on cancer, when its impact is so obvious to all of us? This issue of the Journal contains two articles that try to address this question while estimating the value of life lost due to cancer (2,3). The authors use approaches that economists have used for decades to value morbidity and mortality effects of disease in monetary terms.
Bradley et al. (3) determine the cost of cancer in terms of lost productivity. Productivity is a measure of human capital: the value of the labor one contributes to society. Because not all labor is compensated with wages, Bradley et al. also value nonwage labor related to caregiving and housekeeping, which is commonly but not exclusively provided by women at home. Yabroff et al. (2) take a more expansive view of the cost of cancer, using estimates of willingness to pay for a year of life. This approach not only encompasses productivity effects but also includes intangible benefits, for example, the value of avoiding the pain and suffering that accompany cancer. Economists tend to favor the willingness-to-pay method because it conforms best to the underlying principles of standard welfare economic theory. Transactions in most markets take place with money—our purchases of cars, toothpaste, and meals at restaurants reflect the value we place on those items. Because we generally do not purchase health care the same way we buy other goods and services, economists have developed several methods to ask how much we would be willing to pay for the benefits that are afforded from health care, including years of life. Participants’ responses to a number of direct and indirect surveys have led some economists to estimate that in the United States, we value a year of life between $100,000 and $300,000 on average.
