Epistemic and non-epistemic values in economic evaluations of public health

We review methods for economic evaluation recently developed in health economics by focusing on the epistemic and non-epistemic values they embody. The emphasis is on insights into valuing health, health states or resource management, against conventional approaches using QALY and DALY. The main hypothesis is that economic evaluation and related allocations of economic resources for health and healthcare could be improved by jointly adopting robust methods and broader normative theories within contemporary liberal-egalitarianism. Here, Amartya Sen’s Capability Approach (CA), which shifts attention away from individuals’ preferences for different health, healthcare options and utility maximisation, thereby provide more accurate evaluations of people’s states of health and their objective needs. This combination establishes a beneficial interplay between crucial epistemic values (objectivity-impartiality, consistency, evidence) and non-epistemic values (fairness-equity, redistributive justice). Thus, it is expected to amend methods and normative concepts for economic evaluations of public health in a genuine ‘extra-welfarist’ perspective.