title: Assessing sufficient capability: A new approach to economic evaluation.
abstract: Amartya Sen's capability approach has been discussed widely in the health economics discipline. Although measures have been developed to assess capability in economic evaluation, there has been much less attention paid to the decision rules that might be applied alongside. Here, new methods, drawing on the multidimensional poverty and health economics literature, are developed for conducting economic evaluation within the capability approach and focusing on an objective of achieving "sufficient capability". This objective more closely reflects the concern with equity that pervades the capability approach and the method has the advantage of retaining the longitudinal aspect of estimating outcome that is associated with quality-adjusted life years (QALYs), whilst also drawing on notions of shortfall associated with assessments of poverty. Economic evaluation from this perspective is illustrated in an osteoarthritis patient group undergoing joint replacement, with capability wellbeing assessed using ICECAP-O. Recommendations for taking the sufficient capability approach forward are provided.
authors.affiliation: Health Economics Unit, School of Health and Population Sciences, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: paul.mitchell@kcl.ac.uk.
authors.forename: Paul Mark
authors.initials: PM
authors.lastname: Mitchell
authors.affiliation: Health Economics Unit, School of Health and Population Sciences, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Tracy E
authors.initials: TE
authors.lastname: Roberts
authors.affiliation: Health Economics Unit, School of Health and Population Sciences, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Pelham M
authors.initials: PM
authors.lastname: Barton
authors.affiliation: Health Economics Unit, School of Health and Population Sciences, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Coast
mesh_terms: D003362:Cost-Benefit Analysis / Q000379:methods*; D006801:Humans; D011203:Poverty / Q000706:statistics & numerical data*; D011788:Quality of Life
keywords: Capability approach; Decision rules; Economic evaluation; Multidimensional poverty; Sufficient capability