A Methodological Reference Framework for Identifying and Valuing Intangible Benefits in Cost–Benefit Analysis of Public Health Interventions

Cost–benefit analysis (CBA) is a primary tool for appraising public investments, yet its reliability weakens when interventions generate benefits that are intangible and difficult to monetize. The challenge is acute in public health, where outcomes such as reduced mortal- ity and morbidity, improved quality of life, and greater accessibility rarely have market prices and are therefore often omitted or inconsistently valued. Official CBA guidelines acknowledge these effects but treat them in a fragmented and largely indirect manner, offering limited consolidated guidance on their identification and monetary valuation. This study addresses that gap through a structured comparative analysis of a corpus of 18 official CBA guidance documents issued by governments and international organizations. The resulting methodological reference framework integrates three components: a structured classification of the intangible benefits recurrently associated with health interventions, a systematization of the methodological approaches used for their monetization, and a comparative overview of the use of the value of a statistical life across regulatory contexts. An illustrative correspondence between benefit categories and monetization approaches is derived, indicative rather than prescriptive, since the appropriate technique depends on the intervention, the data available, and the institutional setting. By consolidating guidance currently dispersed across institutional documents, the framework supports more transparent and comparable appraisals of interventions dominated by non-market effects.