Preventing chronic lung disease in an aging society by improved building ventilation : An economic assessment

Leading edge ventilation systems in buildings might slow down the degradation of quality of life in a population. We therefore performed an economic assessment to determine the Incremental Cost-Effectiveness Ratio (the amount of money needed to produce one healthy life year) for a full-scale ventilation upgrade of the building stock in the Netherlands, to increase the healthy lifespan of citizens by preventing and diminishing COPD (Chronic Obstructive Lung Disease), lung cancer and asthma. The upgrade includes a capacity increase of ventilation systems in dwellings and schools, as well as demand-driven ventilation control. Current and upgraded ventilation systems are compared for (i) operating costs, (ii) health care costs, and (iii) DALYs (Disability Adjusted Life Years). This resulted in yearly additional technical operating costs of the upgrade of €13x106 per million inhabitants of the Netherlands. Yearly health benefits per million inhabitants consist of 5,000 DALYs and €23.9x106 of health care expenditure. This leads to an Incremental Cost-Effectiveness Ratio (ICER) for one extra healthy year (DALY) of €18,000, which is an acceptable amount for a healthy life year in the Netherlands. The new ventilation design appears to be cost-effective in preventing and diminishing premature aging of the lungs of Dutch citizens. Future simulation studies are required to increase the accuracy of this assessment.