Assessment of determinant factors of willingness to pay for dengue vaccine: multicenter and cross-sectional study in Southeast Sulawesi, Indonesia

IN3 - How Much do Malaysians Value Dengue Vaccine? Evaluating the Willingness to Pay (WTP) for Hypothetical Dengue Vaccine with Two-Part Model (TPM)

生态保护价值的距离衰减性——以三江平原湿地为例

BackgroundThe escalation of dengue fever (DF) cases in recent years and the occurrence of a large-scale DF outbreak in 2017 underline the importance of dengue vaccines in Vietnam. Given the potential benefits of the dengue vaccines and the need for copayment by the private sector, this study aims to evaluate the willingness to pay (WTP) for the dengue vaccines in patients with DF in Northern Vietnam.MethodsA cross-sectional study was conducted on 330 in-and-out patients with DF admitted to the Bach Mai Hospital. We used the contingent valuation method to evaluate the WTP for dengue vaccines. Socioeconomic and clinical characteristics were also investigated. Multivariate interval and logistic regression models were used to estimate the average amount of WTP and identify the factors associated with the WTP.ResultsAround 77.3% patients were willing to pay an average amount of US$ 67.4 (95% CI=57.4–77.4) for the vaccine. People of higher ages, those having health insurance, those traveling in the past 15 days or suffering from anxiety/depression were less likely to be willing to pay for the dengue vaccine. However, people having a longer duration of DF or having problems with mobility were positively associated with WTP for the dengue vaccine. Patients educated to more than high school levels (Coeff.=31.31; 95% CI=3.26–59.35), those in the richest quintile (Coeff.=62.76; 95% CI=25.40; 100.13), or those having a longer duration of the disease (Coeff.=6.18; 95% CI=0.72–11.63) were willing to pay a higher amount.ConclusionThis study highlights a relatively high rate and amount of WTP for the dengue vaccine among patients with DF. Psychological counseling services as well as educational campaigns should be undertaken to improve the WTP for the vaccine. Moreover, government subsidies should be given to increase the coverage of the vaccine in the future, especially for the poor.

Our study estimates the willingness to pay (WTP) for the dengue fever vaccination program at a national level in Cambodia. A double bounded format with an open-ended question was used in this study to estimate the WTP. The contingent valuation method (CVM) scenario was created as a two-year dengue fever vaccination program. Two vaccine levels were used, one with 40% and another with 80% effectiveness, neither with any side effects. Three doses were required for full protection. We used a 600-split sample survey in Phnom Penh, Cambodia of those aged 20-60 years old and with Cambodian nationality. Subjects were asked how much they would be willing to pay for dengue fever vaccination via a 1-time income tax surcharge of either 50,000, 150,000, 200,000, 350,000, 500,000, or 600,000 riel, respectively. As shown by the Tobit Model, the mean of households’ willingness to pay to support the dengue fever vaccination program were 98,841 riel and 149,124 riel for the 40% and 80% levels, respectively. Income, gender, marital status, and education were the key factors influencing households' WTP to support a dengue fever vaccination program.

Objective: HIV has infected approximately 75 million people worldwide with over half dying from AIDS-related diseases. This study aimed to determine individuals’ willingness to pay (WTP) for future HIV vaccines. Methods: A cross sectional study was conducted in December 2022 in Southern Vietnam with 1 675 face-to-face interviews. WTP was determined using the contingent valuation method with two bidding games under three vaccine efficacy scenarios (high, medium, low) for both self-vaccination and child vaccination. Results: Among 1 655 valid respondents, 553 were willing to pay for their children’s vaccination. Overall, the WTP of adults for the HIV vaccine was (4961 264±3793 652) VND (23700 VND = 1 US dollar). The WTP of parents is (4947 799±4930 721) VND for self-vaccination and (4865 399±4064 567) VND for vaccinating their children. Average WTP decreased with lower vaccine efficacy and lower bid prices. Education level, marital status, occupation, and monthly income were significantly associated with WTP for all vaccination types. Conclusions: In this study, high WTP rates and numerous individuals willing to pay for HIV vaccines were found. These findings can help decision-makers understand factors influencing WTP for future HIV vaccines and provide evidence for developing funding programs and budgeting plans for introducing such vaccines in Vietnam.

Stated preference method is usually used to evaluate the non-market value of environmental goods which includes contingent valuation method (CVM) and choice experiments (CE). In this paper, stated preference method was adopted to evaluate the non-market value of Sanjiang Plain wetland. A willingness to pay (WTP) evaluation model of stated preference method was constructed based on the random utility theory. The average WTP of CVM and CE was obtained, respectively. The average WTP elicited by CE was 379 yuan per year, and the marginal WTPs of different selection properties including water conservation, wetland area, natural landscape and biodiversity were114.00, 72.55, 59.55 and 37.09 yuan per year, respectively. Meanwhile, the average WTP elicited by CVM was 134 yuan per year. The influence of factors on WTP was analyzed and reasons for protest responses were discussed. Results showed that the respondents' WTP elicited by CE was signi-ficantly higher than that by CVM, and respondents' socio-economic attitudes such as level of education and personal annual income had a significant positive impact on respondents' WTP. There were no significant difference in the reasons of protest responses between CVM and CE. Besides, respondents' multiple attributes and multiple levels analysis could be carried out by CE and the WTP of wetland's selection attributes could be calculated. Therefore, CE had the better ability of revealing respondents' preference information than CVM and its assessment results were more close to the actual value.

BackgroundPayment methods for human papillomavirus (HPV) vaccine could substantially influence vaccination behavior. In China, HPV vaccination uptake remains currently low. This study aims to determine willingness to pay (WTP) for HPV vaccines among Chinese female health care workers under different payment scenarios.MethodsThis is a nationwide online survey recruiting female health care workers aged 18–45 years from 31 provinces throughout China. We collected the respondents’ vaccination status of HPV vaccines and their sociodemographics. Two WTPs were defined and estimated in the study. A general WTP for HPV vaccination was determined using the contingent valuation method with double dichotomous choice bidding. A WTP out-of-pocket was estimated for each HPV vaccine under two scenarios, including partial coverage by governmental subsidy or partial incorporation in basic medical insurance. Accordingly, a multivariable linear regression model was employed to determine the association between sociodemographis and general WTP. Then the maximum WTP out-of-pocket was compared among the respondents’ attitude shift towards HPV vaccination, payment scenarios, and levels of vaccine attributes, using non-parametric Kruskal-Wallis test.ResultsA total of 15,969 respondents were included in the study. The median general WTP was 2000 CNY (interquartile range, 1000–3200 CNY), positively associated with younger age, unmarried status, higher monthly income, fewer children, more positive vaccination behavior, working in tertiary hospital, higher local GDP and HDI (each P < 0.05). Moreover, the median WTP out-of-pocket was 1250 CNY (540–2000 CNY). It was significantly higher for vaccines partly covered by governmental subsidy (median, 1250 CNY; interquartile range, 560–2000 CNY), imported vaccines (1260 CNY; 630–1960 CNY), and 9-valent vaccines (1400 CNY; 750–2240 CNY) (each P < 0.001). Additionally, majority of respondents did not change their attitude towards HPV vaccination between two payment scenarios; those remaining with more expensive HPV vaccines (51.1%) had higher WTP out-of-pocket (1400 CNY; 560–2250 CNY) than those with cheaper vaccines (39.0%) (1120 CNY; 490–1960 CNY) (P < 0.001).ConclusionChinese female health care workers have high WTP for HPV vaccines. A direct public funding for HPV vaccination is more preferable. Our findings may facilitate the adjustment of HPV vaccination strategy and payment mechanism in China.

Willingness to pay for public health services in rural Central Java, Indonesia: Methodological considerations when using the contingent valuation method

BackgroundHealth-care workers (HCWs) are among the highest risk groups for COVID-19 infection. The vaccine is found to be vital for HCWs, their household contacts, and their patients to protect against COVID-19 infection and maintain the safety of health systems. The actual willingness to pay for COVID-19 vaccination and associated factors remain uncertain among health-care workers in Ethiopia. Therefore, studying health-care workers’ willingness to pay (WTP) for COVID-19 vaccination helps to have an insight on valuation of the vaccine.MethodsInstitution-based cross-sectional study was conducted among 403 randomly selected health-care workers working in health facilities in eastern Ethiopia from February 3 to March 20, 2021. Pretested structured questionnaire was used to collect data. Binary logistic regression analysis was fitted to test the associations between outcome and explanatory variables. A p-value of <0.05 with 95% confidence interval was used to declare statistical significance.ResultsThe magnitude of willingness to pay for a COVID-19 vaccine was 42.8%. The median amounts of money respondents willing to pay was 400 ETB (US$ 10.04). Sex (male, AOR = 2.33; 95% CI: 1.39, 3.93), monthly income (>7000 ETB, AOR = 1.22; 95% CI: 1.11, 2.51), affordability (AOR = 1.99; 95% CI: 1.18, 3.35), fear of side effects (AOR = 3.75; 95% CI: 2.13, 6.60), support vaccinations (AOR = 2.97; 95% CI: 1.65, 5.35), the likelihood of getting COVID-19 infection (AOR = 2.11; 95% CI: 1.26, 3.52) were independent determinants of WTP for a COVID-19 vaccine.ConclusionHealth-care workers’ willingness to pay for COVID-19 vaccination was found to be low. Detailed health education and training about COVID-19 vaccines are required regarding their side effects, and efficacy to make an informed decision to enhance the willingness to pay for the vaccine. Moreover, the government should consider providing COVID vaccines free of charge for low-income groups and at an affordable price for those who could pay.

South Sulawesi Province has many interesting tourist destinations to be visited by local and foreign tourists which present lots of beautiful oceans, mountainous nature, local wisdom, customs, traditions, and culinary tourism. Tourism is one of the affairs that can be managed by the Regional Government. This is the main reason researchers are interested in analyzing the valuation of the economic value of Rammang-Rammang in Maros Regency. This research is quantitative research with a survey method, namely conducting field observations and direct interviews with respondents using questionnaires as a data collection tool which is then analyzed quantitatively. The economic value of the rammang-rammang natural tourist attraction for the Environmental Services Produced is based on Direct Use Value (use value) as measured by the Travel Cost Method (TCM) approach for Domestic Visitors totaling 49,979 people in 2022, namely IDR. 65,228,992,312,- Per Year, with an Average Travel Cost (ATC) for Respondents of IDR. 1,305,128,- / Person Per Visit. The economic value of the rammang-rammang natural tourist attraction for the environmental services produced based on non-use value is measured using the Contingent Valuation Method (CVM) by asking about visitors' willingness to pay (Willingness to Pay) voluntarily. Domestic, totaling 49,979 people in 2022, which is Rp. 5. 968,558,819,- Per Year, with an Average Willingness to Pay Value of Respondents of IDR. 122,564,-/person Per Visit. Total Economic Value of the rammang-rammang natural tourist attraction for the Environmental Services produced based on the Direct Use Value (use value) measured using the Travel Cost Approach (Travel Cost Method, TCM) and Non-Use Value (Nonuse value) measured using the method ( Contingent Valuation Method, CVM) by asking individuals' willingness to pay voluntarily for domestic visitors totaling 49,979 people in 2022, namely IDR. 71,197,551,130.7,- Per Year. Potential Revenue Amount for Plastering Rammang-Rammang Natural Tourism Objects based on Voluntary Willingness to Pay (WTP) of visitors for Domestic visitors in 2022, totaling 49,979 people excluding the Entry Price (HTM), which is IDR. 71,197,551,130.7,- Per Year. If it coincides, the number of domestic visitors in 2023 will be 40,551 people, based on the average value of domestic visitors in 2021-2022, then the value of willingness to pay domestic visitors voluntarily to participate in preserving nature in 2023 will be IDR. 4,842,654,488,- Per Year, excluding Entry Ticket Price (HTP)

Tourists’ willingness to pay for biodiversity conservation and environment protection, Dalai Lake protected area: Implications for entrance fee and sustainable management

The aim of the paper is to estimate and assess residents' willingness to pay to improve air quality in the urban area of Beijing using the Contingent Valuation Method (CVM). The mean willingness to pay (WTP) for a 50% reduction of harmful substances in the air was 143 CNY per household per year, and the total WTP of the residents in the study area was 336 million CNY per year. As a proportion of household annual income, the mean WTP amounted to 0.7%. Four socio-economic variables were found to have significant impacts on residents' willingness to pay. The analysis results illustrated that WTP increases with income and education level, and decreases with household population and age. The willingness was larger for residents in the urban districts than those in the suburban districts. It was found that most of the protest bids lay on interviewees' incomplete perception of the values of environmental amenity. The influence of household income on people's willingness to pay illustrated in this study reflects a causal force of Beijing's transition to market economy that households created to have disposable income are more likely to care about environmental quality. The results of this study strike an optimistic note on the possibility of measuring the total economic value of environmental quality improvement by using the CVM in China. Suggestions on implication of the CVM for both academics and policy makers are provided in the paper.

Dengue fever is caused by the dengue virus (DENV) which is transmitted to humans through mosquito bites (Aedes aegypti) with a high morbidity rate of up to 20% of those affected by dengue fever. In Indonesia, dengue fever has to get the serious attention from various parties because this disease is endemic and threatening the public health. A multicentre cross-sectional approach was carried out on 642 parents in Southeast Sulawesi. The technique sampling used simple random sampling technique. Research data analysis used descriptive and inferential analysis. Descriptive analysis was used to describe sociodemographic characteristics, experiences, knowledge and acceptance of parents in Southeast Sulawesi. Meanwhile, inferential analysis was used to find out the factors that influence the parents’ acceptance in Southeast Sulawesi. The average value of parents' acceptance and knowledge of the dengue vaccine was 77.1% respectively. The results of the chi square test showed that 4 factors directly influenced the acceptance of the dengue vaccine, those were income, experience of knowing about the vaccine, source of information, and level of knowledge of the respondent with p value of &lt;0.05. It is necessary to increase knowledge of the health workers to the parents to increase the awareness of the benefits of dengue vaccine so that parents in Southeast Sulawesi received the dengue vaccine.

Natural environments provide a wide variety of goods and services to a country's population. Many of these goods and services are provided indirectly — that is, there is no explicit link between the service providers and the users of the services. This is usually due to the spatial separation between the environmental services providers and the users of the same environmental service.As a result, Ecosystem managers have little economic incentive to improve environmental management, the environment is often degraded in many places and the environmental services are not enough for users. The survey of Willingness To Pay (WTP) and the analysis of influencing factors are of great help to the establishement of ecological compensation mechnism. Contingent Valuation Method (CVM) is adopted to evaluate WTP of local residents along Jinhua River Basin for environmental services and Ordered Probit Model & Binary Probit Model is used to analyze the influencing factors of the maximum WTP and the payment mode. The results indicate that, among those residents, 78.4% residents have the WTP, with average maximum WTP of RMB 24.87 per household/month and RMB 298.46 per household/year; maximum WTP has a positive correlation with education level and income; importance of environment to economy shows little significant influence on maximum WTP; age and maximum WTP follow quadratic function relation; the importance of environment to economy and education level lead to the larger probability to pay the ecological compensation taxes; gender, age, whether suffered from pollution disaster or not and maximum WTP have no obvious influence on residents' choice of payment modes.

In 2019, Bangladesh has grappled with a record-breaking surge in dengue fever, experiencing the highest number of dengue cases since the year 2000. Together, the intensification of dengue fever combined with a lack of dengue vaccines and appropriate medicines is expected to further the public and government’s interests in appropriate and potential dengue vaccines to control the epidemic. We considered people’s characteristics, dengue experience, and knowledge to assess their willingness-to-accept (WTA) and willingness-to-pay (WTP) for a hypothetical dengue vaccine and ex-post treatment in Bangladesh (June–July 2019). This study implemented a contingent valuation (CV) method with 3,251 respondents in 10 different locations of Bangladesh. All respondents participated in a hypothetical dengue vaccine scenario consisting of 65% (vaccine A), 80% (vaccine B), and 95% (vaccine C) effectiveness levels with three doses of each vaccine and ex-post dengue treatment. Around 71.2% of respondents were willing to pay for at least one of the hypothetical vaccines: A, B, or C. The average WTPs of the three vaccines amounted to US$ 47.0, US$ 66.0, and US$ 89.0, which were defined as the total cost of the doses necessary to obtain immunity. In Bangladesh, there is a significant demand for low-priced dengue vaccines, which was proven by people’s higher acceptance of vaccination practices. Though dengue vaccines are not yet available in Bangladesh, this study provides significant support that both the government and private sectors should work together to develop a reliable and affordable dengue vaccine.