Practical Application to Include Disease Costs (PAID)

Incorporating indirect costs in economic evaluations with a simple user friendly tool.

With the Practical Application to Include Disease cost (PAID) tools, one can estimate unrelated medical costs in life years gained (and in some cases also costs of non-medical costs in life years gained) which are relevant in economic evaluations if healthcare interventions improve survival. There are tools available for the Netherlands and the UK, with the plan to add further country tools in the future. Find the free PAID tools here.

For the conceptual model and technical details underlying all PAID tools, we refer to van Baal, P.H., Wong, A.,Slobbe, L.J., Polder, J.J., Brouwer, W.B.,de Wit G.A. (2011) Standardizing the inclusion of indirect medical costs in economic evaluations. Pharmacoeconomics 29(3):175-87. Please also cite this text when using any of the PAID tools.


The original PAID for the Netherlands was developed at ESHPM in collaboration with RIVM and consists of tools in Excel (PAID 1.0 and PAID 1.1) and R Shiny (PAID 3.0) in which users can select diseases they want to exclude from the estimates of per capita health care expenditures in order to prevent double counting of costs. The most recent version of PAID is PAID 3.0 and it is advised to use this version in economic evaluations. However, older versions of PAID (PAID 1.0 and PAID 1.1) can still be downloaded. All these versions of PAID are based on Costs of Illness data from the Netherlands ( PAID 3.0 also facilitates to include the costs of non-medical consumption in life years gained. More details on PAID 3.0 and worked out case studies can be found in:  Kellerborg, K., Perry-Duxbury, M., de Vries, L., & van Baal, P. (2020). Practical guidance for including future costs in economic evaluations in the Netherlands: introducing and applying PAID 3.0. Value in Health, 23(11), 1453-1461. Please also refer to this publication when reporting results using PAID 3.0.


You can access the free online PAID 3.0 tool including user manual HERE


[Older versions of PAID]

You can download PAID 1.1 and its user manual here

You can download PAID 1.0 and its user manual here



UK PAID was developed at ESHPM and consists of an R Shiny tool in which users can obtain estimates estimate of per capita health care expenditures. Cost estimates in UK PAID 1.0 were based on average Hospital Episode Statistics (HES) and mortality data from 2013. These age and gender specific per capita average costs per health care provider were decomposed into costs that are incurred in the last year of life and costs that are incurred in other years using various data sources. More details on UK PAID can be found in:  Perry-Duxbury, M., Asaria, M., Lomas, J., & van Baal, P. (2020). Cured today, ill tomorrow: a method for including future unrelated medical costs in economic evaluation in England and Wales. Value in Health, 23(8), 1027-1033. Please also refer to this publication when reporting results using UK PAID.

You can access the free online UK PAID tool including user manual HERE



For questions relating to PAID please send an e-mail to Pieter van Baal ( and state ‘PAID’ in the subject line.