Willingness to pay methods in health care: a sceptical view

Cookson, Richard

doi:10.1002/hec.847

Cited by 104 publications

(82 citation statements)

References 17 publications

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“…17 Our study presents a number of limitations of the experimental nature of CV surveys. 18,19 Typically, the reported willingness to take the test and to pay for testing in this study is only a proxy for actual uptake of testing and true willingness to pay. In addition, our survey design, particularly the wording of the questionnaire, the sequence in which scenarios were presented, and the initial bidding amount, is likely to have influenced the WTP responses.…”

Section: Discussionmentioning

confidence: 99%

Willingness to pay for genetic testing for inherited retinal disease

et al. 2014

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This paper investigates the willingness of adults with inherited retinal disease to undergo and pay for diagnostic genetic testing in three hypothetical scenarios and to explore the factors that influence decision making. Fifty patients were presented with three scenarios whereby genetic testing provided increasing information: confirming the diagnosis and inheritance pattern alone, providing additional information on future visual function, and identifying in addition a new treatment which could stabilise their condition. Willingness to pay (WTP) was elicited using an iterative bidding game. Regression analysis was used to investigate the probability of agreeing to and paying for testing. Qualitative data were also reviewed to provide a comprehensive understanding of WTP and decision making. The majority of participants agreed to undergo genetic testing in each of the three scenarios. Scenario 2 was the least acceptable with 78% of participants agreeing to genetic testing. The probability of agreeing to genetic testing decreased with age. Between 72 and 96% of participants reported a WTP for genetic testing. Average WTP was d539, d1516, and d6895 for scenarios 1, 2, and 3 respectively. Older participants and participants with higher incomes were willing to pay more for testing. Qualitative data provided additional detail about the rationale behind participants' decisions. The study suggests that patients with inherited retinal disease were willing to undergo and to pay for diagnostic genetic testing, suggesting that they valued the information it may provide. However, several patients preferred not to receive prognostic information and were less willing to pay for genetic testing that yielded such detail.

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Section: Discussionmentioning

confidence: 99%

Willingness to pay for genetic testing for inherited retinal disease

et al. 2014

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“…That said, varying methodologies (e.g., bidding game, surveys, consensus) and potentially conflicting perspectives (societal versus private insurance, policy holders versus patient-advocates) in deriving WTP have led to its highly variable estimation, such that health economists have remained skeptical of the validity of WTP, if not insisting on an outright rejection [22,23].…”

Section: Cost-benefit Analysis (Cba)mentioning

confidence: 99%

Health Economic Evaluation: A Primer for Healthcare Professionals

Leung¹

2016

Primary Health Care

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Fundamental Concepts Costs, benefits, supply and demandIn any non-utopic society, resources (or goods) are finite (hence scarce) and they are constantly distributed to individuals to satisfy their needs (wants and preferences). Resources have to be produced (by sellers) to replenish consumption by individuals(consumers), who willingly let go of other resources (money) to accrue the resource(s) of their preference (consumer choice). Such transaction (bought and sold) between a consumer and seller is a re-allocation of resources (supplier's good versus consumer's money) at a mutually agreed price, where consumers' willingness to pay meets sellers 'willingness to accept. Here, consumers enjoy a benefit from the good/service by paying sellers the costs of the goods. In any market free from monopoly or regulation, this transaction price indicates equilibrium between supply and demand ( Figure 1).However, when more than one individual consume the same set of resources, competition will arise: as the net resources decrease the equilibrium price will shift, so that only the individual(s) who can now pay a higher price will continue to consume the decreasing resources. On the contrary, when resources become more available than needed, an excess will be left around and hence the demand falls and pulls down the equilibrium price. John Locke, an English philosopher and physician, first described this inverse supply-demand relationship in his writings in 1691, but the actual term "supply and demand" was not coined until 1767 by Denham-Steuart and Adam Smith, in his famous work of "the Wealth of Nations" [1,2]. By definition, supply and demand for any resource or commodity are susceptible to external constraints like weather (under-or over-production) and disasters that will compromise human viability (under-demand of luxurious items and over-demand of basic commodities) (Figure 2). Scenarios when supply and demand curves shift. For a commodity X in a society, there exists an equilibrium where supply curve S1 intersects demand curve D1, at the agreedutility(price) of U3 for a Q4 quantity of X. An epidemic came killing 15% of population and sent the economy to recession, shifting the demand curve for X to the left to D2 (now less people in total and less money earned). If the supply remained the same S1, it will be relatively in excess and hence the agreed utility (price) will fall to U4 for a lesser quantity of X (Q3). Now, if the production of X also fell, the supply curve will be shifted up to S2(harder to produce the same unit of good/service), leading to a higher agreed utility/price of U2 for a much less quantity of X.(Q1). AbstractIn its broadest term, economic evaluation (EE) is a comparative analysis of the input (costs) and the output (consequences, outcomes) of two or more alternatives to see if they are economically beneficial or feasible. The earliest form of economic evaluation took place in mid-19th century and since then; three main forms of EE have evolved which are employed in various settings: cost-benefit ...

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“…Payor decisions are similarly derived from multiple inputs, but intermingled with economics, cost-effectiveness, societal values, politics, ethics, and epidemiological information. 6 The purpose of the scoring manual is to clearly defi ne events felt by the sleep community to be of physiological signifi cance. To this end, the AASM has led efforts to standardize defi nitions of sleep and, pertinent to this discussion, respiratory event scoring so that the same sleep study will result in roughly the same interpretation in all sleep centers if the scoring rules are applied.…”

Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 99%

Capitulation or Advocacy for Sleep Physicians and Patients?

Morgenthaler

Thomas

Berry

2014

Journal of Clinical Sleep Medicine

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T he letter to the editor by Thomas et al. in this issue 1 makes several assertions as they provide a thoughtful critique and history of defi nitions of the apnea hypopnea index (AHI ), specifi cally as they pertain to evaluating obstructive sleep apnea syndrome (OSA):1) that the differing AASM defi nitions for AHI over the years have been capricious and not based upon "a thorough review of the literature," 2) that the AASM has irresponsibly made concessions to payors in choosing certain defi nitions of the AHI, and 3) that the AHI is an insuffi cient metric for best categorizing disease, and that we should have more clearly named options for polysomnographic events related to sleep apnea. Before addressing these assertions, we applaud many meritorious points in the letter. Thomas et al. nicely highlight issues that most will agree are vexing problems in the science of our fi eld. We are speaking about a complex disease that involves neurological, cardiovascular, and neuroendocrine abnormalities that is currently simplistically defi ned by a fairly primitive measure of respiratory function regularity (the AHI, by whatever defi nition). While, on the one hand, there is a clear need to move beyond this metric, which correlates only poorly with many outcomes and manifestations of the disease, the corpus of literature that serves our community has used this measure to both defi ne the presence and severity of obstructive sleep apnea. Although imperfect, this literature-using this limited measure-presently serves as the foundation of our current practice regarding OSA. We entirely agree that there is and has been a need for solid sleep research to discern more reliable, less expensive, and more relevant diagnostic and prognostic approaches for diagnosing and describing this increasingly prevalent disease.We believe, however, that the editorial inadvertently blurred the distinction between several separate issues. One relates to the development and purpose of a scoring manual, another relates to how one defi nes a disease, and yet another relates to how payors decide what they will reimburse. These are quite distinct, but do interact at times. A scoring manual is built to serve

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Willingness to pay methods in health care: a sceptical view

Abstract: No Abstract

Cited by 104 publications

References 17 publications

Willingness to pay for genetic testing for inherited retinal disease

Willingness to pay for genetic testing for inherited retinal disease

Health Economic Evaluation: A Primer for Healthcare Professionals

Capitulation or Advocacy for Sleep Physicians and Patients?

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