Willingness to Pay for Health Improvements Using Stated Preferences: Prevention Versus Treatment

Abstract

This study aimed to investigate whether there was a difference in willingness to pay (WTP) between prevention and treatment for health benefits of equal magnitude. Methods:We used a web-based survey instrument in a sample of the Swedish general population to perform a contingent valuation study assessing the WTP for prevention and treatment. We analyzed the WTP as a continuous variable using a twopart regression model to adjust for a mass point around 0 and a skewed distribution among respondents with a positive WTP. Results:The study found that people were less willing, on average, to pay at all for prevention than treatment, but those who were willing to pay for prevention had a higher WTP than for treatment. The latter effect was more substantial, and in total mean WTP for prevention was about 85% higher than for treatment. Conclusions:The findings from this study contribute to the ongoing discussion on the appropriate cost-effectiveness thresholds by adding prevention as a parameter affecting the demand-side value of health improvements. As such, it can provide support to decision makers in healthcare and in health promotion priority setting.

Willingness and ability to pay for breast cancer treatment among patients from Addis Ababa, Ethiopia: A cross-sectional study

“…Thus, we found that with increasing income, patients were more able but less willing to contribute to a higher amount of treatment costs. This result is consistent with studies conducted in Bangladesh, Sweden, and Ethiopia had found that the impact of income on WTP for medical care was negligible [56][57][58][59].…”

Determinants of willingness to pay for health services: a systematic review of contingent valuation studies

“…tax, donation, or lump sum [22]), the anchoring effect (relates to the amount of starting bid) [44], the CV method used [29], the scope effect [9,85], or the framing effect [66] can bias WTP estimates. Nevertheless, only ten studies [9,22,26,41,62,63,66,67,75,79] included variables on the study design in the regression model to explain a possible influence on WTP. This result suggests that methodological variables, which could be helpful to control for bias related to the study design, are underrepresented in regression models analysing WTP.…”

“…The CV study design, the types of the regression models, and the format of the WTP variable differ between studies, as described in detail in Table 2. Twenty-eight studies applied a bidding game with double-bonded dichotomouschoice questions or more than two bidding questions, 13 studies [9,22,29,[51][52][53][54][55][56][57][58][59] used single dichotomous choice, 13 studies [60][61][62][63][64][65][66][67][68][69][70][71] applied payment cards, and 13 studies [62,64,66,[72][73][74][75][76][77][78][79][80][81] applied open questions as the primary survey method for WTP. Five studies [29,62,64,66,80] applied more than one WTP format.…”

Residential open space and the perception of health benefits: How much is the public willing to pay?

“…First, the current data were skewed to women and young residents, and more research on the elderly would be valuable as elderly citizens may live in older residential areas that need improvement and spend more time in ROS. Second, a constrained payment scale was used in this study, and the respondents' WTP may have been limited by the constraints, causing biased results (Wolff et al, 2020). To examine the validity of the estimation, other payment-elicitation methods, such as dichotomous choice, should be considered.…”