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WTP and WTA: do people think differently?

David K Whynes1, Tracey H Sach

  • 1School of Economics, University of Nottingham, Nottingham NG7 2RD, UK. david.whynes@nottingham.ac.uk

Social Science & Medicine (1982)
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Summary

Willingness to accept (WTA) for healthcare interventions may differ significantly from willingness to pay (WTP). This study found mean WTA values were four times mean WTP, highlighting potential issues in cost-effectiveness analyses.

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Area of Science:

  • Health Economics
  • Decision Analysis
  • Medical Technology Assessment

Background:

  • Contingent valuation (CV) in healthcare primarily uses willingness to pay (WTP), largely ignoring willingness to accept (WTA).
  • Disparities between WTP and WTA are documented outside healthcare, potentially impacting cost-effectiveness assumptions.
  • Investigating WTA-WTP for healthcare technologies is crucial for accurate economic evaluations.

Purpose of the Study:

  • To assess the feasibility of estimating willingness to accept (WTA) for discontinuing existing healthcare technology.
  • To investigate potential disparities between WTA and willingness to pay (WTP) for paediatric cochlear implantation (PCI).

Main Methods:

  • Utilized data from interviews with users of the UK's paediatric cochlear implantation (PCI) programme.
  • Employed contingent valuation (CV) methods to elicit both WTA and WTP values.
  • Conducted qualitative analysis to understand differences in valuation approaches.

Main Results:

  • Only one-third of participants could provide both WTP and WTA values.
  • Qualitative data indicated the presumption of fungibility was a greater obstacle for WTA than WTP.
  • Among those providing both, mean WTA was approximately four times mean WTP.

Conclusions:

  • Estimating WTA for healthcare interventions presents feasibility challenges compared to WTP.
  • A significant disparity exists between WTA and WTP for paediatric cochlear implantation.
  • Further research is needed to determine if these findings are intervention-specific or elicitation-format specific.