Higher Willingness To Pay Values Research Articles

Millennials and automated mobility: exploring the role of generation and attitudes on AV adoption and willingness-to-pay

ABSTRACT Results from a recent travel behavior survey are used to examine the impacts of generational and attitudinal factors on autonomous vehicle (AV) adoption and willingness to pay (WTP). Initial exploratory data analysis confirmed generational differences in various aspects of travel behavior. A structural equation model (SEM) was developed to capture the causal effects of different variables on AV adoption/WTP. In particular, Interaction effects with generational cohorts were analyzed. Generally, it could be inferred that WTP significantly and positively affects adoption levels, so do technology savviness, the desire for driving assistance/higher safety features, and mobility for non-drivers. The WTP is also affected by income, employment status, and previous technology experience. Further, our model suggests that millennials who appreciate the on-demand aspect of AVs are more likely to adopt a fully or partially automated vehicle. The middle-aged cohort (35–39 years old) as well as transit-user millennials are likely to have higher WTP values.

A preference for quality: Australian general public's willingness to pay for home and residential aged care

In Australia and many other countries internationally, aged care services are provided to older people in their own homes or residential care facilities. The majority of these services are funded by the federal government using taxpayer contributions from the general public. However, the monetary value Australians place on aged care services, and the factors that predict this value, have not been examined. We, therefore, sought to determine the general public's willingness to pay (WTP) for aged care services and examine which factors influence this WTP. A cross-sectional contingent valuation survey was administered to a nationally representative cohort of 10,285 Australians between September and October 2020 from the general population aged 18 years and over. Respondents were asked to indicate their WTP values for satisfactory and high-quality aged care services to be provided in the future. A two-part regression model was used to explain what factors explained variation in WTP. In total, 80% (61%) of respondents were willing to pay to access satisfactory (high) quality home care (counterpart figures for residential care were 64% (45%)). On average, respondents were willing to pay between $126 and $158 ($145 and $237) per week to receive satisfactory-quality (high-quality) home care and between $333 and $520 ($308 and $680) per week for satisfactory-quality (high-quality) residential care. Respondents were willing to pay an additional $120 per week on average to access high-quality aged care. Higher WTP values were generally associated with being younger, male, recent experience with aged care through a close family member accessing aged care and ability to pay. These results suggest general public support for payment of individual co-contributions to access aged care services in the future.

Willingness to pay for a quality-adjusted life year for depressive disorders compared to heart disease based on population preferences

PurposeAccording to estimations of the World Health Organization, depressive disorders, and cardiovascular disease will be the leading causes for global burden of disease in 2030. The aim of the present study was to estimate the value a representative sample of the German population places on quality-adjusted life years (QALYs) for depressive disorders compared to heart disease.MethodsA representative sample of N = 967 of the German general public was randomly presented with one of two hypothetical health-loss scenarios: One version of the questionnaire presented respondents with health loss due to depression, while the other version dealt with health loss due to experiencing a heart disease. Respondents were asked to indicate their willingness to pay (WTP) for four hypothetical health-gain scenarios with different treatment options.ResultsIn the depression questionnaire median WTP values ranged from 1000 to 1500 EUR; in the heart disease questionnaire from 1000 to 2000 EUR. Results of the Mann–Whitney U-Test and Median Test indicate higher WTP values for heart disease compared to depressive disorders when QALY gains were minor and stretched over a long period of time, and when treatment with bypass operation (rather than treatment with ECT) was offered. Zero WTP was significantly higher in all scenarios of the depression questionnaire in comparison to the hearth disease questionnaire.ConclusionResults indicate that respondents valued the necessity of paying for treatment higher when presented with heart disease compared to depression.

Optimizing the risk threshold of lymph node involvement for performing extended pelvic lymph node dissection in prostate cancer patients: a cost-effectiveness analysis

BackgroundExtended pelvic lymph node dissection (ePLND) may be omitted in prostate cancer (CaP) patients with a low predicted risk of lymph node involvement (LNI). The aim of the current study was to quantify the cost-effectiveness of using different risk thresholds for predicted LNI in CaP patients to inform decision making on omitting ePLND. MethodsFive different thresholds (2%, 5%, 10%, 20%, and 100%) used in practice for performing ePLND were compared using a decision analytic cohort model with the 100% threshold (i.e., no ePLND) as reference. Compared outcomes consisted of quality-adjusted life years (QALYs) and costs. Baseline characteristics for the hypothetical cohort were based on an actual Dutch patient cohort containing 925 patients who underwent ePLND with risks of LNI predicted by the Memorial Sloan Kettering Cancer Center web-calculator. The best strategy was selected based on the incremental cost effectiveness ratio when applying a willingness to pay (WTP) threshold of €20,000 per QALY gained. Probabilistic sensitivity analysis was performed with Monte Carlo simulation to assess the robustness of the results. ResultsCosts and health outcomes were lowest (€4,858 and 6.04 QALYs) for the 100% threshold, and highest (€10,939 and 6.21 QALYs) for the 2% threshold, respectively. The incremental cost effectiveness ratio for the 2%, 5%, 10%, and 20% threshold compared with the first threshold above (i.e., 5%, 10%, 20%, and 100%) were €189,222/QALY, €130,689/QALY, €51,920/QALY, and €23,187/QALY respectively. Applying a WTP threshold of €20.000 the probabilities for the 2%, 5%, 10%, 20%, and 100% threshold strategies being cost-effective were 0.0%, 0.3%, 4.9%, 30.3%, and 64.5% respectively. ConclusionApplying a WTP threshold of €20.000, completely omitting ePLND in CaP patients is cost-effective compared to other risk-based strategies. However, applying a 20% threshold for probable LNI to the Briganti 2012 nomogram or the Memorial Sloan Kettering Cancer Center web-calculator, may be a feasible alternative, in particular when higher WTP values are considered.

The cost-effectiveness of epidural, patient-controlled intravenous opioid analgesia, or transversus abdominis plane infiltration with liposomal bupivacaine for postoperative pain management

Study objectiveIntravenous patient-controlled opioid analgesia (IVPCA), epidural analgesia and transversus abdominis plane (TAP) infiltrations are frequently used postoperative pain management modalities. The aim of this study was to conduct a cost-effectiveness analysis comparing the use of epidural, IVPCA, and TAP infiltrations with liposomal bupivacaine for analgesia in the first 72 h postoperatively in patients undergoing major lower abdominal surgery. DesignRetrospective cost effectiveness analysis. SettingOperating room. PatientsWe obtained data on major lower-abdominal surgeries performed under general anesthesia on adult patients between January 2012 and July 2014. InterventionsA cost-effectiveness analysis was comparing the use of epidural, IVPCA, and TAP infiltrations with liposomal bupivacaine for analgesia in the first 72 h postoperatively. MeasurementsA decision analytic model was used to estimate the health outcomes for patients undergoing major lower abdominal surgery. The primary outcome was time-weighted pain from 0 to 72 h after surgery, as measured by numerical rating scale pain scores. The analysis was conducted from the perspective of the hospital as the party responsible for most costs related to surgery. Main resultsFrom the base case analysis, IVPCA was the optimal strategy regarding cost and effect. TAP with LB, however, was only narrowly dominated, while epidural was clearly dominated. From the sensitivity analysis at willingness-to-pay (WTP) of $150, IV PCA and TAP infiltration were each the optimal strategy for approximately 50% of the iterations. At WTP of $10,000, epidural was only the optimal strategy in 10% of the iterations. ConclusionsThis is the first study in the literature to compare the cost-effectiveness of epidural, IVPCA, and TAP infiltrations with LB. Within reasonable WTP values, there is little differentiation in cost-effectiveness between IVPCA and TAP infiltration with LB. Epidural does not become a cost-effective strategy even at much higher WTP values.

What Drives Responses to Willingness-to-pay Questions? A Methodological Inquiry in the Context of Hypertension Self-management.

Background: The use of economic evaluation to determine the cost-effectiveness of health interventions is recommended by decision-making bodies internationally. Understanding factors that explain variations in costs and benefits is important for policy makers. Objective: This work aimed to test a priori hypotheses defining the relationship between benefits of using self-management equipment (measured using the willingness-to-pay (WTP) approach) and a number of demographic and other patient factors. Methods: Data for this study were collected as part of the first major randomised controlled trial of self-monitoring combined with self-titration in hypertension (TASMINH2). A contingent valuation framework was used with patients asked to indicate how much they were willing to pay for equipment used for self-managing hypertension. Descriptive statistics, simple statistical tests of differences and multivariate regression were used to test six a priori hypotheses. Results: 393 hypertensive patients (204 in the intervention and 189 in the control) were willing to pay for self-management equipment and 85% of these (335) provided positive WTP values. Three hypotheses were accepted: higher WTP values were associated with being male, higher household incomes and satisfaction with the equipment. Prior experiences of using this equipment, age and changes in blood pressure were not significantly related to WTP. Conclusion: The majority of hypertensive patients who had taken part in a self-management study were prepared to purchase the self-monitoring equipment using their own funds, more so for men, those with higher incomes and those with greater satisfaction. Further research based on bigger and more diverse populations is recommended.

Ist ein neues Arzneimittel sein Geld wert? Wessen Geld? – Bewertung eines neuen Diabetes-Präparats mit Hilfe eines Discrete-Choice-Experiments

This study seeks to provide evidence for deciding whether or not a new preparation for the treatment of diabetes should be included in the benefit list of social health insurance. A discrete-choice experiment (DCE) was conducted in Germany to measure preferences for modern insulin therapy using long-acting insulin analogue “insulin detemir” in comparison to NPH insulin. The DCE contains two price attributes, co-payment and increased contributions to health insurance, as well as four properties of the insulin, i.e. risk of hypoglycemia, weight gain, need for preparing the insulin before injection, and flexibility in time of the injection. Of the 1,110 individuals interviewed in 2007, 202 suffered from type 1, 154 from insulin-treated type 2, and 152 from insulin-naive type 2 diabetes. This allows to compare ex-ante and ex-post willingness-to-pay (WTP). Non-diabetics and insulin-naive diabetics exhibit higher WTP values through co-payment, while affected type 1 and insulin-treated type 2 diabetics have higher WTP through increased contributions. However, WTP values exceed the extra treatment cost in both financing alternatives, justifying inclusion of the new drug in the benefit list from a cost-benefit point of view.

Accounting for Systematic Influences on Preference Heterogeneity in Air Travel

Modeling passengers' itinerary choice behavior helps in understanding the increasingly competitive airline market and in predicting air travel demand. Recently, investigation of the variation in passengers' preferences with regard to factors influencing their choice through estimation of the mixed multinomial logit model has received attention. An extended form of the model identifies sources of heterogeneity and consequently makes the choice models less restrictive in considering both systematic and random preference variation across individuals. This research investigates the existence of significant interactions between passengers' preference heterogeneity around the mean of random parameters in estimated utility functions and observed sociodemographic or trip-related attributes in the case of air travel. Unlike previous research in the literature that has focused on choice behavior modeling in mature markets with relatively high per capita rates of air travel activity, this study centers on a survey of travelers in Tehran, Iran, a low-propensity air travel market. Several distributions for random parameters are considered to test the impacts of restricting distributions to allow only normality. The potential to improve model fit with alternative distributions was confirmed. The findings suggest that differences in the marginal utilities can be explained mostly by differences in travel experience. More experienced passengers are less sensitive to fare and more sensitive to flight level-of-service attributes. Furthermore, the estimated distributions of willingness-to-pay (WTP) measures confirm the value of accounting for interactions between preference heterogeneity and observed variables and in this case yield higher mean WTP values than does analysis that omits these interaction effects.

The relationship between reliability and size of willingness‐to‐pay values: a qualitative insight

In a previous paper, the reliability of willingness-to-pay (WTP) values was found to be an increasing function of the size of WTP expressed. Here, the results of a qualitative exercise conducted alongside this quantitative study are presented. The results of this exercise suggest that higher WTP values may require more thought from the respondent which, in turn, gives them greater stability. At low levels of WTP, values appear to be taken from a 'discretionary account', where expenditure is more volatile. Caveats to this result, and suggestions for future research, are considered in the discussion.

Car drivers' willingness to pay for not losing their driving licence

The aim of this article is to discuss theoretically and to study empirically how Norwegian drivers' willingness to pay (WP) for not losing their driving licence vary with their personal characteristics. The theoretical discussion and empirical results are based on standard microeconomic theory and contingent valuation, respectively. The WP values increase concavely with the length of the suspension period of the driving licence and differ greatly between drivers. They increase significantly with a driver's income, dependence on the car at work and driving experience. Moreover, male drivers, young drivers and drivers living in rural areas have higher WP values than their counterparts. Consequently, driving licence suspension will deter drivers to different extents. The relative impacts of the above explanatory variables on the WPs are, broadly speaking, independent of the length of the suspension period.