We develop a framework for quantifying monetary values associated with changes in disease-specific mortality risk in low- and middle-income countries to help quantify trade-offs involved in investing in mortality reduction due to one disease versus another. We monetized the changes in mortality risk for communicable and non-communicable diseases (CD and NCD, respectively) between 2017 and 2030 for low-income, lower-middle-income, and upper-middle-income countries (LICs, LMICs, and UMICs, respectively). We modeled three mortality trajectories (“base-case”, “high-performance”, and “low-performance”) using Global Burden of Disease study forecasts and estimated disease-specific mortality risk changes relative to the base-case. We assigned monetary values to changes in mortality risk using value of a statistical life (VSL) methods and conducted multiple sensitivity analyses. In terms of NCDs, the absolute monetary value associated with changing mortality risk was highest for cardiovascular diseases in older age groups. For example, being on the low-performance trajectory relative to the base-case in 2030 was valued at $9100 (95% uncertainty range $6800; $11,400), $28,300 ($24,200; $32,400), and $30,300 ($27,200; $33,300) for females aged 70–74 years in LICs, LMICs, and UMICs, respectively. Changing the mortality rate from the base-case to the high-performance trajectory was associated with high monetary value for CDs as well, especially among younger age groups. Estimates were sensitive to assumptions made in calculating VSL. Our framework provides a priority setting paradigm to best allocate investments toward the health sector and enables intersectoral comparisons of returns on investments from health interventions.

中文翻译：

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低收入和中等收入国家不断变化的死亡风险的经济价值：按死因进行系统细分

我们开发了一个框架，用于量化与低收入和中等收入国家特定疾病死亡风险变化相关的货币价值，以帮助量化投资降低一种疾病与另一种疾病导致的死亡率所涉及的权衡。我们将 2017 年至 2030 年低收入、中低收入和中上收入国家（LIC、LMIC 和 UMIC）的传染病和非传染性疾病（分别为 CD 和 NCD）的死亡风险变化货币化， 分别）。我们使用全球疾病负担研究预测和估计的疾病特定死亡风险相对于基本案例的变化，对三个死亡率轨迹（“基本案例”、“高性能”和“低性能”）进行了建模。我们使用统计生命价值 (VSL) 方法为死亡风险的变化分配了货币价值，并进行了多重敏感性分析。就非传染性疾病而言，与死亡风险变化相关的绝对货币价值在老年组心血管疾病中最高。例如，相对于 2030 年的基本情况，处于低绩效轨迹上的价值为 9100 美元（95% 的不确定性范围为 6800 美元；11,400 美元）、28,300 美元（24,200 美元；32,400 美元）和 30,300 美元（27,300 美元；女性年龄为 27,300 美元）3 – 分别在 LIC、LMIC 和 UMIC 工作 74 年。将死亡率从基本情况更改为高性能轨迹也与 CD 的高货币价值相关，尤其是在较年轻的年龄组中。估计值对计算 VSL 时所做的假设很敏感。