Imperial College London


Faculty of MedicineSchool of Public Health

Professor of Global Health



+44 (0)20 7594 1150timothy.hallett




Norfolk PlaceSt Mary's Campus






BibTex format

author = {Haacker, M and Hallett, T and Atun, R},
doi = {heapol/czz127},
journal = {Health Policy and Planning},
pages = {107--114},
title = {On discount rates for economic evaluations in global health},
url = {},
volume = {35},
year = {2020}

RIS format (EndNote, RefMan)

AB - Choices on discount rates have important implications for the outcomes of economic evaluations of health interventions and policies. In global health, such evaluations typically apply a discount rate of 3 percent for health outcomes and costs, mirroring guidance developed for highincome countries, notably the United States.The paper investigates the suitability of thes eguidelines for global health (i.e.,with a focus on low and middleincome countries), and seeks to identify best practice. Our analysis builds on an overview of the academic literature on discounting in health evaluations, existing academic or governmentrelated guidelines on discounting, are view on discount rates applied in economic evaluations in global health, and crosscountry macroeconomic data. The social discount rate generally applied in global health of 3 percent annually is in consistent with rates of economic growth experienced outside the most advanced economies. Forlow and lowermiddle income countries, a discount rate of at least 5 percent is more appropriate, and one around 4 percent for uppermiddle income countries. Alternative approaches–e.g., motivated by the returns to alternative investments or by the cost of financing–could usefully be applied, dependent on policy context. The current practise could lead to systematic bias toward overvaluing the future costs and health benefits of interventions. For health economic evaluations in global health, guidelines on discounting need to be adapted to take account of the different economic context of low and middleincome countries.
AU - Haacker,M
AU - Hallett,T
AU - Atun,R
DO - heapol/czz127
EP - 114
PY - 2020///
SN - 0268-1080
SP - 107
TI - On discount rates for economic evaluations in global health
T2 - Health Policy and Planning
UR -
UR -
UR -
VL - 35
ER -