Prolonging lives with self-management

COMPAR-EU aims to rank the most (cost-)effective interventions for self-management and provide relevant research supporting this aim. In two recently published papers we provide standardized methods for the inclusion of future costs in cost effectiveness analyses, in the Netherlands [1] and England and Wales [2] respectively.

29. March 2021 | by Meg Perry-Duxbury & Pieter van Baal | Institute for Medical Technology Assessment (iMTA)

What do you need to know about future costs and cost effectiveness analysis?

‘Future costs’ are costs that are incurred in life years gained if a preventive intervention or medical treatment postpones death. Imagine that because of a self-management intervention a person with diabetes is able to lower his/her weight and better control HbA1c, and thereby prevents a fatal heart attack and lives longer. Because of these survival benefits this person will consume medical care (and also other goods and services) in added life years. The costs of this consumption in added life years are called future costs.

The literature shows that future costs need to be included in cost-effectiveness analysis if the aim is to maximize population health given constrained resources [3].

In both of the published papers we lay out the methods that can be used, with aggregate population data, to estimate future costs for a particular intervention. These vary between the two countries due to different perspectives of healthcare decision makers and the data available.

Findings from these methods

Our findings show that future costs rise with age and with the amount of life-years gained from the intervention in question. Alongside our two papers we have published two separate online tools, both under the name ‘PAID’ which are freely available, that allow researchers doing cost-effectiveness analyses to download the future medical costs specific to their intervention. This removes several hurdles from the otherwise time-consuming process of including future unrelated medical costs and future non-medical costs in economic evaluation. This will lead to less biased estimates of cost-effectiveness and provide more reliable rankings of self-management interventions.


Pieter van Baal

Pieter van Baal is Associate Professor in Health Economics at Erasmus School for Health Policy and Management (ESPHM). His research focuses on methods for cost-effectiveness analysis, measuring and forecasting population health, the economics of prevention and ageing and the modelling of chronic diseases.

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Meg Perry-Duxbury

Meg Perry-Duxbury is finishing her PhD in Health Economics at Erasmus University Rotterdam, and now works at TU Delft as an Open Science trainer. Her research has focused on how we can account for future health events in health care decision-making. Meg holds a master’s degree in Economics from Erasmus University Rotterdam.


  1. Kellerborg, K., Perry-Duxbury, M., de Vries, L., & van Baal, P. (2020). Practical Guidance for Including Future Costs in Economic Evaluations in The Netherlands: Introducing and Applying PAID 3.0. Value in Health, 23(11), 1453-1461.
  2. Perry-Duxbury, M., Asaria, M., Lomas, J., & van Baal, P. (2020). Cured Today, Ill Tomorrow: A Method for Including Future Unrelated Medical Costs in Economic Evaluation in England and Wales. Value in Health, 23(8), 1027-1033.
  3. de Vries L,M., van Baal P,H.M., Brouwer WBF. Future costs in cost-effectiveness analyses: Past, present, future. 2019;37:119-130.


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