Neurology -- Correspondence for Frenzen, 71 (1) 21-27

Correspondence published:

Economic cost of Guillain-Barré syndrome in the United States: Gregory L. Pittman (29 August 2008)

Reply from the author: P.D. Frenzen (29 August 2008)

Economic cost of Guillain-Barré syndrome in the United States 29 August 2008

Gregory L. Pittman
#56, 3900 Kresge Way, Louisville, KY 40207
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Re: Economic cost of Guillain-Barré syndrome in the United States

gpittman{at}nsapsc.com Gregory L. Pittman

One of the apparent goals of Dr. Frenzen’s article is to make an effort to increase the final sum of the cost. [1] Thus, there is a concerted effort to generate sums from a mixture of sources and some are valid.
I understand examining health care costs, and to some extent lost productivity costs for those who later return to work. In my opinion, this is not the same for the category, "Premature death costs." The frank and perhaps sad truth is that the cost of a premature death is dubious, and likely nonexistent. The question: "What is a human life worth?" is emotional, not economic.
For example, if the premature death of a CEO of a major corporation is compared to that of a homeless person, it may be concluded that the CEO’s death is a large cost to society and the homeless person's either zero or of monetary benefit. It could be argued that either of these premature deaths is not an economic detriment or benefit to society. The CEO will be replaced and society may not economically react to the death of a homeless person.
As physicians, we care for patients regardless of these economic issues because we chose our careers for reasons other than the economic benefit to society. Therefore, it is important to keep these separate reasons separate, and not artificially assign monetary value to everything.
Reference
1. Frenzen PD, Economic cost of Guillain-Barré syndrome in the United States. Neurology 2008;71:21-27.
Disclosures: The author reports no disclosures.

Reply from the author 29 August 2008

P.D. Frenzen,
Economic Research Service, USDA
1800 M Street, N.W., Washington DC 20036
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Re: Reply from the author

pfrenzen{at}ers.usda.gov P.D. Frenzen

Pittman suggests that the value of a human life is an emotional question, not an economic issue. In fact, estimates of the economic value of a life are routinely used by governments to inform decisions about how finite resources should be allocated to prevent premature deaths. [2] Economists have developed several different methods to estimate the economic value of a life, one of which is the “value of a statistical life". This statistical approach is widely used for cost-benefit analyses of proposed government regulations to reduce illness and death from hazards such as contaminated food or air pollution. However, the value of a statistical life is not intended for comparing the value of different individuals, and sheds little or no light on ethical questions about the worth of any particular person.
The correct value of a statistical life remains a subject of debate among economists. I used a widely cited estimate of the value by Viscusi to determine the economic cost of Guillain-Barré syndrome in the United States (GBS). [1] The Viscusi estimate indicates that about 60% of the total cost of GBS is due to deaths. Other reported estimates of the value of a statistical life would have raised or lowered this proportion, but would not have altered the basic conclusion that much of the economic cost of GBS is due to deaths. Omitting the cost of deaths would therefore have provided a misleading picture of the economic impact of GBS.
Reference
2. Viscusi, WK. The value of risks to life and health. J Econ Lit 1993;31:1912–1946.
Disclosures: The author reports no disclosures.