10.6084/m9.figshare.4770526.v1 Christopher Sampson Christopher Sampson Marilyn James Marilyn James Putting the ‘extra’ in animal welfare: health maximisation for non-human animals figshare 2017 Health economics cost-effectiveness Economic evaluation animal health Veterinary science health state valuation QALY extra-welfarism healthcare health technology assessment animal welfare ISESSAH Health Economics Public Health and Health Services not elsewhere classified 2017-03-21 14:18:17 Poster https://figshare.com/articles/poster/Putting_the_extra_in_animal_welfare_health_maximisation_for_non-human_animals/4770526 Economic evaluation in human health care tends to adopt an 'extra-welfarist' approach. The key manifestation of extra-welfarism is the maximisation of health within a given budget. We outline the extra-welfarist framework and evaluate its applicability to various contexts of animal welfare. Many of the reasons for the adoption of an alternative to classical welfarist approaches in humans are pertinent to animals. With a focus on the tools used for health state valuation in humans, we explore potential approaches to health state valuation in animals. Common preference elicitation techniques including time trade-off, standard gamble and choice experiments are outlined. The nature of trade-offs between health-related quality of life and longevity, and the potential role for a quality-adjusted life year (QALY) approach in animals, is explored. We consider the feasibility and validity of alternative perspectives for animal health state valuation including self (i.e. animal’s own health preferences), human companion, livestock manager and society. Furthermore, we explore the potential for novel methods of valuation, including a person/animal trade-off. To illustrate the potential for extra-welfarism in animal health, we compare and contrast its application to end of life decisions in humans and in animals. In this context, difficult decisions are necessary in trading off quality and length of life, which might be traumatic for animals and their owners. A key advantage of the extra-welfarist approach is its flexibility, which could accommodate the varying contexts and perspectives for animal health state valuation. Determination of the most suitable approach to animal health state valuation depends on the ethical principles assumed by the analyst, and necessarily differs according to the perspective being evaluated. We outline the importance of defining perspectives in the context of animal welfare and specify key ethical principles associated with alternative approaches.