Which health endpoints accrue medical expenses or lost earnings for multiple years, and

how do I discount them?

BenMAP includes health and valuation functions for several chronic health effects, including PM2.5

–related chronic bronchitis and non-fatal acute myocardial infarctions (AMIs, or heart attacks).

Technically, AMIs are discrete, acute events, not chronic conditions. However, heart attacks

cause chronic follow-up health effects that accrue medical expenses over time, similar to chronic

conditions. You can discount the economic value of these chronic effects through the valuation

function in BenMAP. Chronic bronchitis is assumed to last from the initial onset of the illness

throughout the rest of the individual’s life. BenMAP currently includes one WTP function as well

as two COI functions representing the two discount rates for chronic bronchitis. AMIs are

assumed to accrue costs over five years. Although WTP functions for AMIs are not available,

BenMAP currently includes several COI functions that incorporate the direct medical costs and

the opportunity cost (lost earnings) for specific age groups at two discount rates. See Appendix I

for details on the discounting assumptions within the valuation functions.

 

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