Estimating a return on investment (ROI), Benefit-Cost Ratio (BCR) or net benefits utilizing a benefit-cost analysis (BCA) analytical approach is commonly applied to major policy or regulatory changes or large-scale investments where there are multiple impacts across a range of constraints and sectors and the objective is to represent the impact and distribution on societal welfare. Health impacts of interventions can be monetized utilizing concepts such as the value of statistical life (VSL) informed by valuation of mortality or morbidity risk reduction. Converting all positive and negative impacts into monetary form enables aggregation using a common metric which enables clear and simple communication of results. Applying a BCA framework to DHI investments will require consideration of how the value categories introduced in the impact inventory can be monetized. Methodology for monetization of Health Value, Processes Value, and Cross-sector Value impacts are largely in common with established BCA methods. If a total monetized summary metric is required in the analysis, the bespoke approaches would need to be adopted for monetization of Evidence generation value, Prediction Value, and Disruption Potential, with careful consideration required to ensure correct attribution and avoidance of double counting. Some emerging approaches that may be applicable for monetization of DHI-specific impacts are detailed in table 7, and it is expected that ongoing methods research will generate more tailored methods.

**Table 7  Approaches for monetization of DHI-specific impacts**

|**COMPONENT**|**ESTABLISHED/EMERGING APPROACHES TO**<br>**MONETIZATION**|
|---|---|
|Health value|Value of Statistical Life (Robinson et al 2019) [38]|
|Process value|Efficiency analysis (Durrett et al) [39]<br>Time preference (Whittington & Cook 2019) [40]<br>Contingent Valuation(Bayoumi 2004) [41]|
|Cross-sectorial value|Economy-wide effects (Strzepek et al 2018) [42]|
|Evidence generation value|Data Shapley (Ghorbani & Zou 2019) [43]<br>Value of DataAssets (First San Francisco) [44]|
|Prediction value|Scenario analysis – preliminary development (Agrawal et al<br>2019) [45]|
|Disruption potential value|Analysis of potential future scenarios with valuation|

A social return on investment (SROI) analysis is a form of BCA. Building on the approach for estimating ROI it explicitly attempts to identify and isolate wider social benefits from immediate financial returns of an investment and is useful where there are particular benefits that are considered socially desirable by a decision maker and that should be explicitly represented.

The major types of value aggregation are detailed in table 8.

**Table 8 key features of different types of value aggregation**

|**TYPE OF VALUE**<br>**AGGREGATION**|**REPRESENTATION**|**INCORPORATES**|**INTERPRETATION**<br>**REQUIRES**|**FURTHER**<br>**METHODOLOGICAL**<br>**GUIDANCE**|
|---|---|---|---|---|
|**Cost-benefit**<br>**analysis**|Benefit-cost ratio: net<br>benefits, return on<br>investment|Full costs and<br>benefits converted<br>to monetized|<br>Understanding of<br>valuation technique,<br>particularly health|Benefit-Cost Analysis<br>Reference Case [4]|
|||form to extent<br>possible|benefits||