Can we objectively measure the human cost of disease?

Abstract

Economic evaluation of health care programs or technologies requires distinguishing three types of costs: direct, indirect and human. The first two types do not imply peculiar methodological issues to quantify them, even though all researchers do not accept the use of a market prices system. Excluding such different views to calculate in monetary terms these items, evaluation of direct and indirect costs is quite objective. Discussing human costs expressed in quantitative and qualitative terms, we note that they have to be meant as subjective costs. Nevertheless, researchers created health indicators such as QALYs and DALYs, often used in health care studies. Their subjective characteristics require more theoretical discussions about some issues such as the meaning of "quality of life" and "utility". The lack of a general acceptance of these indicators does not permit their use in health care policy decisions.