Wellbeing & Capability

Group lead: Jo Coast


This theme is developing methodology for economic evaluation in complex settings where broader assessments of costs and outcomes are required. Approaches to enable such assessment within sound theoretical frameworks, particularly including Sen’s Capability Approach, are being developed.

Our research group

There are four broad themes within the programme:

A. Examining the underlying theory of capability and how it relates to economic evaluation.

B. Developing, valuing and validating economic measures of outcome that include, and go beyond, health gain.
B1. Developing measures
B2. Valuing measures
B3. Validity assessment

C. Exploring decision rules for decision-making.

D. Exploring the process of estimating efficiency and equity using different evaluative spaces within the contexts of primary research and secondary modelling.

The programme particularly focuses on generic measurement of capabilities (Coast, Al-Janabi, Kinghorn, Mitchell, Keeley), and the measurement of outcomes in specific areas where moving beyond health is important: end of life care (Coast, Kinghorn, Bailey, Canaway), sexual and women’s health (Roberts, Frew, Sanghera, Jackson, Kinghorn), children in relation to obesity (Frew, Canaway) allergy (Diwakar, Roberts), and informal care (Al-Janabi, Coast, Goranitis, Bhaduri). It is also exploring the use of Willingness to Pay methods in contexts where a broader set of outcomes beyond health is important (Frew, Sanghera, Roberts), and the use of broader assessments of cost, including productivity cost (Kigozi, Barton, Jowett, Coast), to set against these assessments of well-being in economic evaluation.

Within this programme, new methods have been developed to assess the benefits of health and social care interventions, based on the underlying theory of Amartya Sen’s capability approach (Coast, Al-Janabi). The validity of the ICECAP-O and ICECAP-A measures has been established within the general population and their assessment is ongoing in user populations, including musculoskeletal patients (Keeley, Coast, Al-Janabi, Oppong, Kigozi, Jowett), depression sufferers (Mitchell, Coast, Al-Janabi), patients with urge incontinence (Roberts, Goranitis), opiate users and their families (Frew) and weight loss patients (Frew). Validity assessments are also being undertaken for ICECAP-SCM (Bailey, Kinghorn, Coast) and the Carer Experience Scale (Goranitis, Al-Janabi, Coast). New methods to incorporate health spillovers in economic evaluation are being developed and work has been undertaken on measuring benefits of end of life care for economic evaluation. ICECAP measures are currently being used in Australia, Canada, USA, Netherlands; and France, as well as the UK. In the UK they are recommended for the evaluation of social care interventions by both NICE and SCIE.

Current research projects

  • Coast J. The economics of end of life care. ERC Starting Grant. 2011-2014. 999,177 Euros
  • Al-Janabi H. Measuring and modelling the ‘spillover’ effects of healthcare interventions. MRC Early Career Research Fellowship. 2011-2014. £330,252. (Sponsor: Coast J).
  • Richardson J, Cummins R, Olsen J, Kaplan R, Schlander M, Coast J. The validity of 8 instruments used to include quality of life in economic evaluation in 8 disease areas and 6 countries. Australian National Health and Medical Research Council. 2011-2014. Aus$822,660.

Recent publications

  • Al-Janabi H, Keeley T, Mitchell P, Coast J. Can capabilities be self-reported? A think-aloud study. Social Science and Medicine. 2013; 87: 116-122.
  • Mitchell PM, Roberts TE, Barton PM, Pollard BS, Coast J. Predicting the ICECAP-O capability index from the WOMAC Osteoarthritis Index: Is mapping onto capability from condition-specific health status questionnaires feasible? Medical Decision Making. 2013;33(4):547-557. doi:10.1177/0272989X12475092
  • Jackson LJ, Auguste P, Low N, Roberts TE. Valuing the Health States Associated with Chlamydia trachomatis Infections and Their Sequelae: A Systematic Review of Economic Evaluations and Primary Studies. Value in Health. 2014;17(1):116-130.
  • Sutton E, Coast J. Development of a supportive care measure for economic evaluation of end-of-life care, using qualitative methods. Palliative Medicine. 2014;28:151-157.
  • Flynn TN, Huynh E, Peters TJ, Al-Janabi H, Moody A, Clemens S, Coast J. Scoring the ICECAP-A capability instrument. Estimation of a UK general population tariff. Health Economics. Online first: doi: 10.1002/hec.3014


PI(s): Hareth Al-Janabi, Pelham Barton, Jo Coast, Emma Frew, Sue JowettTracy Roberts

Postdocs: Cara Bailey, Ilias Goranitis, Louise Jackson, Jesse Kigozi, Phil Kinghorn, Raymond Oppong, Sabina Sanghera.

Doctoral students: Arjun Bhadhuri, Alastair Canaway, Lavanya Diwakar, Tom Keeley.