Is there a kink in consumers threshold value for cost-effectiveness in health care?
Author InfoBernie J. O’Brien Kirsten Gertsen (University of Nijmegen, Netherlands) Andrew R. Willan A. Faulkner (Centre for Evaluation of Medicines, St Joseph’s Hospital, Hamilton, Ont., Canada) Abstract Background: A reproducible observation is that consumers’ willingness-to-accept (WTA) monetary compensation to forgo a program is greater than their stated willingness-to-pay (WTP) for the same benefit. Several explanations exist, including the psychological principle that the utility of losses weighs heavier than gains. We sought to quantify the WTP-WTA disparity from published literature and explore implications for cost-effectiveness analysis accept-reject thresholds in the south-west quadrant of the cost-effectiveness plane (less effect, less cost). Methods: We reviewed published studies (health and non-health) to estimate the ratio of WTA to WTP for the same program benefit for each study and to determine if WTA is consistently greater than WTP in the literature. Results: WTA|WTP
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