Social, ethical, and other value judgments in health economics modelling

Social Science & Medicine
Volume 253 May 2020


Research article Open access
Social, ethical, and other value judgments in health economics modelling
Stephanie Harvard, Gregory R. Werker, Diego S. Silva
Article 112975
:: Interviews with health economists reinforced philosophical arguments positing a role for values throughout research.
:: Values informed early modelling decisions, model assumptions, and trade-offs between
:: Values played a role in assessing consequences of error and taking action under uncertainty in the modelling process.
Modelling is a major method of inquiry in health economics. In other modelling-intensive fields, such as climate science, recent scholarship has described how social and ethical values influence model development. However, no similar work has been done in health economics. This study explored the role of social, ethical, and other values in health economics modelling using philosophical theory and qualitative interviews in British Columbia, Canada. Twenty-two professionals working in health economics modelling were interviewed between February and May, 2019. The study findings provide support for four philosophical arguments positing an essential role for social and ethical values throughout scientific inquiry and demonstrate how these arguments apply to health economics modelling. It highlights the role of social values in informing early modelling decisions, shaping model assumptions, making trade-offs between desirable model features, and setting standards of evidence. These results point to several decisions in the modelling process that warrant focus in future health economics research, particularly that which aims to incorporate patient and public values.