According to the World Health Organization, “three distinctive characteristics, when combined, make mere variations or health differences into a social inequality in health. They are systematic, socially produced (and, therefore, modifiable) and unfair.
This is how a group of special interest group of ISPOR of Griffiths et al. (2025) starts. The Health Capital Manual provides and overview of literature. The document identifies a series of key social disadvantage sources: “Socio -economic state, race and ethnicity, gender, geographical location, disability”, among others.
While reducing health disparities is a laudable objective, there are a number of other priorities that also go to the social welfare function, including “… concern for efficiency in increasing total health, the concern for prioritizing seriously ill patients and concern to guarantee appropriate decision -making procedures doing. ” For example, if health benefits are valued equally or we should assess the health benefits that accumulate more disadvantaged patients or more serious diseases. Who is health benefits? Should we value more: poor patients who have mild disease or rich patients who have serious diseases? The answers to these questions are not simple. As the document indicates:
… measuring and addressing health disparities is a challenge given the interaction between many complex factors that shape health results and can lead to various ethical concerns.
The document identifies different dimensions through which considering health capital concerns could be useful.
The document also provides examples of distribution profitability analysis applications (DCEA) and extended profitability analysis (ECE). DCEA requires data on at least 4 key dimensions: (i) basal health inequalities (ii) effects of relative distribution treatment, (iii) the distribution of opportunity costs and (iv) aversion to population inequality.
The authors highlight 4 key inequality sources:
- Need: How many patients in a given group have a disease?
- Receipt: Among those in need, how many have access?
- Short -term effects: How are the differences in basal risks for condition, as well as the effects of the intervention?
- Long -term effects. Differences in the opportunity cost of financing innovation
While now we have methods to quantify the impact of new health technologies, there are still barriers. First, it is not clear if key decisions creators understand problems related to health disparities and/or if addressing these inequalities is a priority for them. Secondly, the economic modeling of health disparity is more intensive in the data than standard CEA modeling. Third, health equity is just a dimension of broader social value that interested parties should consider.
For more information on the evaluation of health equity within Hor, I recommend that you read the Complete paper.
