Estimating the Economic Cost of Migraine in Latvia and Lithuania.
.....Ágnes Lublóy, Stockholm School of Economics in Riga; Zane Vārpina, Stockholm School of Economics in Riga
Migraine is a primary headache disorder which affects all aspects of life. The financial burden of migraine imposed on the society is substantial. This study aims at estimating the economic cost of migraine in Latvia and Lithuania, including both direct and indirect costs. Direct costs encompass the costs of migraine-related health care resource utilization. Indirect costs are related to productivity loss, the potential or expected earnings lost due to migraine. We quantify three components of productivity loss: reduced labour force participation, absence from work and reduced productivity while at work. First, we perform a literature review to proxy the prevalence rate of migraine in Latvia and Lithuania, the migraine-related health care resource utilization, the number of days missed from work and the number of days lost due to impairment while at work. Then, we retrieve data such as unit cost of medical services and procedures, unemployment rate and average income in Latvia and Lithuania to estimate the economic cost of migraine in these countries. We deliver a conservative cost estimate; the prevalence rate of migraine and the number of lost workdays adopted from the literature can be considered as lower bounds for those items. We find that the total cost of migraine is €114.29 million in Latvia, corresponding to 0.42% of Latvia’s GDP. The total cost of migraine is €151.83 million in Lithuania, corresponding to 0.36% of Lithuania’s GDP. Around 70% of total cost is indirect cost, a huge majority of which is related to absenteeism and presenteeism. Further cost-benefit analysis could illuminate interventions that lower the indirect cost of migraine without significant cost increase in patients care.
Estimating the Economic Burden of Cardiovascular Disease in Lithuania.
.....Ágnes Lublóy, Stockholm School of Economics in Riga; Teodors Muzis, Stockholm School of Economics in Riga; Rimants Rimants Žogota, Stockholm School of Economics in Riga
Cardiovascular diseases are the primary cause of death worldwide; for 2019 the World Health Organization estimated around 17.9 million deaths globally, representing 32% of all deaths. In Lithuania, cardiovascular diseases are the leading cause of death; and the country has the highest mortality rate from ischaemic heart diseases in the European Union. In addition to the large mortality burden, non-fatal cardiovascular incidents decrease the quality of patients’ life, decrease productivity and increase the need for informal care. Therefore, it is important to assess the impact of cardiovascular disease beyond the health care systems and consider the costs arising from productivity losses and informal care as well. In this research, we first aim at assessing the burden of cardiovascular disease in Lithuania by employing a Markov cohort model with a time horizon of 30 years. We assess both direct healthcare costs and indirect costs. Indirect costs include productivity loss due to absenteeism and presenteeism, and unpaid work loss being replaceable by caregivers. Second, we aim at assessing the potential impact of lowering low-density-lipoprotein cholesterol (LDL-C) by using the novel PCSK9 inhibitors (PCSK9i). We compare the cost of using PCSK9i inhibitors with the benefits of using it, including lower number of hospitalizations, less follow-up healthcare costs, lower productivity loss and lower unpaid work loss. Our holistic perspective enables us to understand the widescale economic and social consequences of cardiovascular diseases in Lithuania.
Excise Tax Policy in the Baltic Countries: Alcoholic Drinks, Soft Drinks and Tobacco Products.
.....Anna Pluta, Baltic International Centre for Economics Policy Studies; Mihails Hazans, University of Latvia; Anna Zasova, Baltic International Center for Economic Policy Studies
The aim of this research is to analyse excise tax policies in the Baltic countries from the point of view of revenues to the state, consumer welfare (including public health) and other policy goals, e.g., creating incentives for product reformulation, and to develop recommendations on excise tax policy. The study covers the following excise goods: alcoholic beverages, tobacco products and soft drinks with added sugar, other sweeteners or flavouring.
There are strong public health reasons for taking measures to discourage excessive consumption of alcoholic beverages, tobacco products, and caloric food products and beverages in the Baltic countries. First of all, Lithuania and Latvia are among the EU countries with one of the highest per capita amounts of pure alcohol consumed. Smoking incidence in the Baltic countries has remained very high over the last two decades. Finally, there is a need to address the problem of growing overweight and obesity in the Baltic countries.
For the Baltic countries, excise duties represent a more important source
of tax revenues compared to richer EU member states and EU countries on average, and excise duties have remained the focus of fiscal policy debates for many years. In 2007-2020, all three Baltic countries have increased their excise duties several times. However, the relative (PPP-adjusted) prices for some excise goods remain relatively low if compared to other EU countries. Thus, in 2018, prices for all tobacco products in the Baltic countries were 32- 37% below the EU-28. There is no such gap in the prices of alcohol, however: in Lithuania, prices for alcohol were on average 6% lower than in the EU-28, while the average relative prices of alcohol in Latvia and Estonia were above the EU average (8.5% higher in Latvia and 26.3% higher in Estonia).
Who Gains, Who Loses? A Baltic Perspective on Distributional Issues in Cost-Benefit Analysis.
.....Dominik Gerber, Stockholm School of Economics in Riga
The traditional economic defense of cost-benefit analysis (CBA) has been driven by a concern for welfare improvement (“growing the pie”), which it hoped to separate neatly from distributional issues. Judgements about the distributional incidence of costs and benefits of a policy project, according to the traditional view, are not the business of economists, but must be left to the political process. A growing body of literature challenges this division of labor and offers both theoretical and practical guidance on accommodating distributional concerns within CBA. Using the example of the “Rail Baltica” project, a EUR 5.8b rail infrastructure project integrating the Baltic States in the European rail network, this paper illuminates the case for applying distributional ‘equity’ weights to the costs incurred and benefits received b Society of Benefit-Cost Analysis 2023 Annual Conferencey different stakeholder groups within the Baltic countries. Special attention will be paid to the considerable cross-Baltic variation in income inequality, public governance quality, and institutional trust, all of which can potentially affect the distributional implications of CBA. Finally, against the background of this contextual variation, this paper compares the distributional implications of CBA with alternative decision procedures frequently employed by government agencies, namely risk-risk analysis, direct multidimensional assessment, and QUALY-based assessment.