Lower Willingness To Pay Research Articles

Sintilimab plus chemotherapy with or without bevacizumab biosimilar IBI305 in EGFR-mutated non-squamous NSCLC patients who progressed on EGFR TKI therapy: A China-based cost-effectiveness analysis.

This study aims to compare the cost-effectiveness of sintilimab in combination with chemotherapy, with or without bevacizumab biosimilar IBI305, versus chemotherapy alone for patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) who have progressed on tyrosine-kinase inhibitor (TKI) treatment from the perspective of the Chinese healthcare system. 10-year Markov model was developed using a 21-day cycle length. Transition probabilities were derived from the ORIENT-31 trial, while cost and health state utilities were obtained from publicly databases, local hospitals, and published literature. Incremental cost-effectiveness ratios (ICERs) were calculated as the primary model output and compared to a willingness-to-pay (WTP) threshold range of $15,289.34 to $38,223.34 per quality-adjusted life-years (QALY). Sensitivity analyses were performed to assess the robustness of the model. In the base-case analysis, sintilimab plus IBI305 and chemotherapy had an ICER of $53,266.32/QALYs, exceeding the upper WTP threshold. Sintilimab plus chemotherapy had an ICER of $15,329.11/QALY, slightly above the lower WTP threshold. Subgroup analysis yielded consistent results. Deterministic sensitivity analyses found no ICER for sintilimab plus chemotherapy beyond the upper WTP threshold. Most model input changes did not decrease the ICER of sintilimab plus IBI305 and chemotherapy below the upper WTP threshold. Probabilistic sensitivity analyses further demonstrated the cost-effectiveness superiority of sintilimab plus chemotherapy over sintilimab plus IBI305 and chemotherapy. This study supports the cost-effectiveness of using sintilimab in combination with chemotherapy. Nevertheless, the cost-effectiveness of combining sintilimab with IBI305 and chemotherapy in this particular patient group may be lacking.

Transfusion burden and willingness to pay for temporary alleviation of anemia status in transfusion-dependent beta-thalassemia patients in China

BackgroundTransfusion-dependent β-thalassemia (TDT) is one of the global public health concerns highlighted by the World Health Organization. Patients with TDT require regular blood transfusion to survive. However, the availability of blood resources is extremely limited. The purpose of this study was to investigate transfusion burden and willingness to pay (WTP) for temporary remission of anemia status among patients with TDT and to explore the associated factors.MethodsAdult patients with TDT were recruited through cluster sampling across several high-incidence provinces in China. Consenting patients completed online questionnaires on demographic information, transfusion burden and WTP with real-time WeChat communication assistance from researchers. The guiding techniques of double-bounded dichotomous choices and open-ended questions in the contingent valuation method (CVM) were used to obtain participants’ WTP for 1 unit of leukocyte-depleted red blood cells. WTP calculations were performed using maximum likelihood estimation, with further insights gained through subgroup analysis based on gender, family monthly income level and convenience of blood transfusion.ResultsThe analysis included 149 TDT patients from five high-incidence provinces, with an average monthly income of $198.5. Patients received an average of 3.7 units per transfusion, 15.4 times annually, with an average WTP of $70.4 per unit (95% CI [62.0, 78.9]). Estimated WTP for temporary anemia alleviation per transfusion totaled $260.6, exceeding monthly income by 1.32 times. Higher WTP was observed among males, higher-income households, and those with at least junior education. Lower WTP was noted among patients with lower transfusion volumes and those needing to travel for transfusion or during hospitalization for blood transfusion.ConclusionHigh WTP indicated a strong desire for temporary anemia relief. Most TDT patients faced significant economic and transfusion burden. The evident gap in meeting clinical needed underscores the urgent demand for innovative treatments to reduce transfusion dependency, potentially transforming TDT care and improving socioeconomic well-being and clinical outcomes. These findings supported evidence-based decision-making for TDT pharmacoeconomics and efficient healthcare resource allocation in China.

Consumers’ willingness to pay for alternative protein food products: taste preference, health, and environmental concerns

ABSTRACT This study investigates consumers’ preferences and willingness to pay (WTP) for traditional animal meat, plant-based meat, and cell-cultured meat products, specifically focusing on beef, chicken, and pork categories. The experiment involves presenting participants with various meat options, along with the presence or absence of carbon footprint or low-salt labels. The findings reveal that consumers exhibit a lower WTP for plant-based and cell-cultured meat compared to traditional animal meat across all three categories (beef, chicken, and pork). Moreover, both carbon footprint and low-salt labels significantly increase consumers’ WTP. The choices made by consumers are influenced by attribute preferences and product-related concerns. Specifically, taste preference significantly impacts consumers’ preference for animal meat over cell-cultured meat in the beef, chicken, and pork categories; however, this effect is not significant for plant-based meat. Consumers who prioritize health concerns tend to choose plant-based beef and chicken over traditional options. Environmental concerns play a crucial role in pork choices, leading to a decrease in the selection of animal pork and an increase in the preference for cell-cultured pork. These findings offer valuable insights for industry stakeholders seeking to advance protein biotechnology and drive innovation in the food market.

A choice experiment for different preparation methods of eggs: The impact of sensory, health, and animal welfare

The risk of salmonella food poisoning increases the lower the degree of heating the eggs.This study investigated the effect of cooking methods on the willingness to pay (WTP) for sterilization method.The choice experiment consisted of eight attributes; yolk color (yellow vs. orange), grade (special vs. first grade), omega-3 (3 levels), egg sterilization method (no sterilization vs. sodium hypochlorite vs. pasteurization), hen feed (antibiotics vs. antibiotic-free vs. organic), hen’s breeding method (caged vs. cage-free), production area (in-prefecture vs. outside of prefecture), and price (5 levels).The online survey included 1,000 Japanese consumers. A within-design was employed in which everyone responded under the assumptions of eating a hard-boiled egg, a soft-boiled egg, and a raw egg.As the degree of heating decreased, the WTP for the sterilization attribute became higher. Sodium hypochlorite was always higher than pasteurization. As the degree of rawness increased, the WTP of antibiotic-free and organic feed rise. However, the organic feed had a lower WTP than the antibiotic-free feed. When eating raw eggs, the WTP of antibiotic-free was the second important compared with the sterilization. As the degree of rawness increased, the WTP of the orange color of the yolk rise, and finally reached three times higher when eating raw eggs than when eating hard-boiled eggs. The WTP of local production was not significantly different in any case. Omega-3 had a significant negative WTP only for raw eggs. Cage-free had a significant negative WTP only for boiled eggs.

Patient’s willingness to pay for improved community health insurance in Tanzania

Globally, achieving universal health coverage remains significant challenge. Health insurance coverage in low- and middle-income countries is still low with only a few African countries managed to reach 50% coverage. This study aimed to investigate the factors influencing patients’ willingness to pay (WTP) for medication and various versions of the improved Community Health Insurance Fund (iCHF) in Tanzania. A facility-based cross-sectional study was conducted in all hospitals, health centres, and eight randomly sampled dispensaries, sampling participant from the queue, one out of every three patient based on their order of entry into consultation room, and interviewed 1,748 patients in Kilombero and Same districts in Tanzania. We used multi-stage Contingent Valuation Methods exploring data collected during client exit interviews. We employed a random utility model and estimated WTP through an ordered logit model. The independent variables were; patient’s gender, age, marital status, education, employment status, Non-Communicable Disease (NCD) status, health insurance status, and the type of healthcare facility level. Our findings revealed that most patients exhibited a WTP of an amount equivalent to the current iCHF premiums and would also be willing to pay for an augmented iCHF premium inclusive of additional medication coverage. Upon adjusting for demographic characteristics, we observed that patients enrolled in an insurance program or benefiting from user fee waivers demonstrated a lower WTP for medication, while those with non-communicable diseases (NCDs) and seeking care in private facilities exhibited a higher WTP. Furthermore, patients with a secondary education level or above generally displayed higher WTP for premiums. Conversely, patients enrolled in private insurance and availing user fee waivers, along with those accessing care in public facilities, demonstrated a lowered WTP for iCHF premiums. These results highlight the need for targeted interventions to address systemic deficiencies and improve access to medicines. Our conclusions is that policies considering NCD status, education levels and income status are important when designing health insurance schemes for the informal sector in Tanzania, with the goal of increasing uptake of CHF.

Decision Support Systems adoption in pesticide management

This paper presents the findings from a survey on factors influencing the adoption of agricultural Decision Support Systems (DSS). Our study focuses on examining the influence of behavioural, socioeconomic and farm specific characteristics on DSS adoption. Using two structural equation models, we investigate how these factors influence the willingness to pay (WTP) and willingness to adopt. Our analysis reveals nuanced insights into the user and farm-specific factors that influence the decision-making process of DSS adoption and WTP. Notably, farm size significantly influences both adoption and WTP, with larger farms more likely to adopt and exhibit higher WTP. To promote adoption, it is important to adapt promotion strategies, with a focus on productivity benefits for large-scale farms and addressing price barriers for smaller ones. Additionally, the main crop type grown impacts WTP and adoption, with arable crop farmers exhibit a lower WTP but more likely to adopt, especially in large-scale operations. Conversely, small-scale arable farmers exhibit higher WTP but lower adoption rates due to scale constraints. Farmer characteristics such as experience and attitudes also play a crucial role, with experienced users and those perceiving productivity improvements due to DSS showing higher WTP. In addition, adoption is also influenced by ease of use and pricing, underpinning the importance of user-friendly designs and clear cost justifications. DSSs with user-centric designs and clear cost justifications can enhance adoption rates.

From Loyalty to Profitability

This paper explores the viability of a paid subscription-based membership model within the staycation sector of the hotel industry, focusing on consumer preferences and willingness to pay (WTP). Amidst the persistent popularity of staycations following the COVID-19 pandemic, this study leverages quadrant analysis to evaluate the importance of WTP for various subscription features proposed by hotels. A significant element of this research involves comparing these preferences against the published rates of comparable hotel services to ascertain the financial feasibility of the proposed model. This research's novelty is that it applies quadrant analysis to investigate the viability of the hotel-paid subscription model. The quantitative method is used to map quadrant analysis based on 49 respondents. Initial findings indicate a generally low WTP among potential consumers, suggesting challenges in aligning the perceived value of subscription benefits with their actual costs. By conducting an independent t-test, the study tests hypotheses concerning the economic viability of the subscription model, ultimately revealing that the low WTP values significantly undermine the potential for profitable implementation. The paper concludes that while the subscription model offers a novel approach to enhancing customer loyalty and operational stability, its success is contingent upon a deep understanding of consumer valuation of proposed benefits, suggesting further investigation into alternative benefits that could align more closely with customer expectations. It can be started by investigating the feasibility of designing a bundling package with a vast network of related industries in tourism and hospitality.

Decision Support Systems adoption in pesticide management

This paper presents the findings from a survey on factors influencing the adoption of agricultural Decision Support Systems (DSS). Our study focuses on examining the influence of behavioural, socioeconomic and farm specific characteristics on DSS adoption. Using two structural equation models, we investigate how these factors influence the willingness to pay (WTP) and willingness to adopt. Our analysis reveals nuanced insights into the user and farm-specific factors that influence the decision-making process of DSS adoption and WTP. Notably, farm size significantly influences both adoption and WTP, with larger farms more likely to adopt and exhibit higher WTP. To promote adoption, it is important to adapt promotion strategies, with a focus on productivity benefits for large-scale farms and addressing price barriers for smaller ones. Additionally, the main crop type grown impacts WTP and adoption, with arable crop farmers exhibit a lower WTP but more likely to adopt, especially in large-scale operations. Conversely, small-scale arable farmers exhibit higher WTP but lower adoption rates due to scale constraints. Farmer characteristics such as experience and attitudes also play a crucial role, with experienced users and those perceiving productivity improvements due to DSS showing higher WTP. In addition, adoption is also influenced by ease of use and pricing, underpinning the importance of user-friendly designs and clear cost justifications. DSSs with user-centric designs and clear cost justifications can enhance adoption rates.

Attributes Influencing Willingness to Pay for Overweight and Obesity Interventions in Adults: A Systematic Literature Review.

This review aims to identify the associated attributes of willingness to pay (WTP) for overweight and obesity interventions.A narrative review was conducted by partially adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline.A non-exhaustive search using a pre-defined strategy and keywords was done on three selected literature databases: Pubmed, Scopus, and Web of Science. The inclusion criteria for the review were original studies written in English, published between 2000 and 2022, and focused on WTP for overweight and obesity interventions in adults. The extracted studies were manually screened for their eligibility through three cascading tiers: the title, the abstract, and the full article. Only nine original studies were eligible for review based on the screening procedure of 40 screened articles. There was heterogeneity in the study designs, methods, target populations, study duration, and perspectives across the studies. The majority of the studies showed that higher WTP was associated with younger age, having higher income, being female, having higher body mass index (BMI), having the perception of being overweight, habits, and attitudes. WTP is also attributed to the associated percentage of weight loss, long-term health risk reduction, time to noticeable weight loss, delivery mode, side effects, lifestyle modification, and costs of interventions.The identification of common attributes of the WTP for overweight and obesity intervention can assist in the formulation and implementation of effective evidence-based policies. Specific sub-groups with low WTP could be targeted via unique initiatives to improve their participation in weight-loss interventions.

PUBLICITY, FACILITIES DIVERSITY AND WILLINGNESS TO PAY FOR HOUSEHOLD WASTE SORTING: NEW EVIDENCE FROM HETEROGENEITY REGRESSION

Household waste sorting is important to actively promote the construction of beautiful countryside and beautiful city via household waste reduction or recycling. The Law of China on the Prevention and Control of Solid Waste Environmental Pollution indicates that household waste treatment fee system follows the principle of “who produces, who pays”, reflecting differentiated management such as classified pricing and metering fees. This research mainly investigates the determinants of willingness to pay (WTP) for household waste sorting in China. This study mainly compares different effects of the waste sorting information publicity, waste sorting facilities diversity, perceived convenience and reference group behavior on WTP via multiple and logistic regression. It also explores gender and regional heterogeneity for WTP of household waste sorting in China. This study also analyzes how individuals respond to different levels of WTP fees of household waste sorting via logistic regression. The empirical results reveal that the facilities diversity of waste sorting has the highest effect on WTP for household waste sorting, followed by perceived convenience, publicity and reference group behaviors. Females have relatively lower WTP than males. Education has significant positive effects on males’ waste sorting WTP. In logistic regression, reference group has larger effect on WTP compared with other antecedents. It is important to enhance facilities and publicity of household waste sorting. This research is of great significance to increase the household waste sorting behavior, enhance the governance system of household waste sorting via the collaboration of government, medias, communities and individuals.

Increased farmer willingness to pay for quality cassava (Manihot esculenta Crantz) planting materials: evidence from experimental auctions in Cambodia and Lao PDR

AbstractVarietal turnover is a major mechanism for farmer adaptation to rapidly changing environmental and market conditions. Understanding factors related to varietal turnover is critical for safeguarding food security in the face of increasingly rapid changes to production contexts. Preference elicitation methods like experimental auctions reveal farmers’ willingness to pay (WTP) for seeds with different characteristics. We engaged farmers growing cassava (Manihot esculenta Crantz) across a wide geographic scope in Cambodia (n = 321, 4 provinces) and Lao PDR (n = 391, 5 provinces) in modified second-price experimental auctions to determine WTP for three cassava seed classes: farmer-produced planting stems of an undescribed variety, farmer-produced planting stems of an elite variety with lower susceptibility to Cassava Mosaic Disease (CMD), and virus-free tested planting stems of the same elite variety. In Lao PDR, mean auction bids for a bundle of 20 planting stems were 0.54, 0.92, and 1.40 USD for farmer, elite, and elite tested stems, while in Cambodia the analogous mean bids were 0.58, 0.77, and 1.16 USD, respectively. A significantly higher WTP associated with elite variety and tested stems in both countries was influenced by both geographic location (province) and individual socioeconomic farmer characteristics. In Lao PDR this included lower WTP of women, higher WTP of ethnic minorities, and, for improved stems, lower WTP of farmers with increased cassava growing experience. In Cambodia fewer socioeconomic variables affected WTP. Our results indicate significant increases in WTP for clean planting materials and new varieties, supporting market-based clean seed approaches as a component of regional control strategies for the CMD epidemic currently threatening a global agri-food value chain.

Are Consumers Equally Willing to Pay More for Brands That Aim for Sustainability, Positive Societal Contribution, and Inclusivity as for Brands That Are Perceived as Exclusive? Generational, Gender, and Country Differences

This study explores consumer preferences for brands that emphasize sustainability and inclusivity, and for brands perceived as exclusive and trendy. Consumer data obtained via a large-scale survey involving 24,798 participants across 20 countries and one special administrative region (SAR) are used to understand how willingness to pay (WTP) for these brand types varies globally, accounting for demographic factors like generation, gender, and country. A substantial body of literature highlights growing consumer interest in brands that stand for sustainability and inclusivity, challenging traditional notions that luxury and exclusivity primarily drive brand value. Despite persistent skepticism among some business executives about consumers’ actual versus claimed willingness to spend more for sustainable and inclusive brands, academics and commercial researchers increasingly signal a shift in purchasing behavior that is influenced by socio-ecological factors. This research aims to provide empirical data on consumer WTP across different demographics and countries/regions, thereby contributing to academic discussions and offering insights for managerial decision making. The study frames its investigation around four research questions, to explore how consumers’ WTP for exclusive and inclusive brands varies across generations, genders, and countries/regions. It employs a robust methodological approach, using confirmatory factor analysis (CFA) and structural equation modeling (SEM) to analyze the data. This ensures that the constructs of brand inclusiveness and exclusivity are comparable across diverse cultural contexts. Significant gender, generational, and country/region differences are observed. When comparing generations, the findings indicate that GenZ consumers have a higher WTP for sustainable/inclusive brands (compared to older, GenX, and Baby Boomer generations). Similar patterns are found when considering WTP for exclusive, on-trend brands. In terms of gender, women are observed to have a higher WTP for sustainable/inclusive brands, but a lower WTP for exclusive, on-trend brands compared to men. Finally, compared to consumers originating from certain European countries, we find that consumers living in certain Asian countries/regions have a significantly higher WTP for inclusive and sustainable brands, as well as for exclusive/on-trend brands. The study underscores the complexities of consumer behavior in the global market, highlighting the coexistence of traditional preferences for exclusive, trendy brands and preferences for brands that embrace sustainability and inclusivity.

Economic valuation of snake conservation in Greece

Snakes are at the same time valuable and vulnerable because they offer many ecosystem services but are also threatened by humans, both directly through persecution and indirectly through habitat destruction. The implicit human fear of snakes often leads to negative attitudes and behaviors. Increasing support and collecting funds are therefore critical for their future survival. We carried out face-to-face interviews of Greek residents (n = 936) for implementing a multiple-bounded discrete choice approach to estimate willingness to pay (WTP), the effects of cognitions, emotions, and sociodemographics on WTP and infer support for snake conservation. A mean annual WTP of €28.0 per household was estimated, suggesting that about €26.6 million per year could be collected during a fundraising campaign. Survey participants had higher mutualism than domination wildlife value orientations and reported moderately low levels of attractiveness and moderately high levels of fear toward snakes. Participants more mutualism-oriented who found snakes more attractive were WTP a higher amount for their conservation than those less mutualism-oriented who found snakes less attractive. Young, females, with higher income, non-farmers, and pet owners were WTP a higher amount for the conservation of snake species than old, males, with lower income, farmers, and non-pet owners. Findings revealed that considerable funds could be collected for snake conservation, further suggesting pro-conservation attitudes among the participants. Further, findings revealed groups with high and low WTP and support of the animals. This information would be valuable if used for creating and implementing tailored education and outreach programs aimed at increasing public support for the protection and survival of snake populations.

Irreversible pulpitis in mature permanent teeth: a cost-effectiveness analysis of pulpotomy versus root canal treatment

IntroductionEvidence-based dentistry suggests pulpotomy as a potential alternative to root canal treatment in mature permanent teeth with irreversible pulpitis. However, the evidence surrounding the cost-valuation and cost-efficacy of this treatment modality is not yet established. In this context, we adopted an economic modeling approach to assess the cost-effectiveness of pulpotomy versus root canal treatment, as this could aid in effective clinical decision-making.MethodsA Markov model was constructed following a mature permanent tooth with irreversible pulpitis in an 18-year-old patient over a lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on existing literature. Costs were estimated based on the United States healthcare following a private-payer perspective and parameter uncertainties were addressed using Monte-Carlo simulations. The model was validated internally by sensitivity analyses, and face validation was performed by an experienced endodontist and health economist.ResultsIn the base case scenario, root canal treatment was associated with additional health benefit but at an increased cost (1.08 more years with an incremental cost of 311.20 USD) over a period of an individual’s lifetime. The probabilistic sensitivity analysis revealed pulpotomy to be cost-effective at lower Willingness-To-Pay (WTP) values (99.9% acceptable at 50 USD) whereas increasing the values of WTP threshold root canal treatment was a cost-effective treatment (99.9% acceptable at 550 USD).ConclusionBased on current evidence, pulpotomy was a cost-effective treatment option at lower WTP values for the management of irreversible pulpitis in mature permanent teeth. However, by increasing the WTP threshold, root canal treatment became a more cost-effective treatment option over a period of lifetime of an individual.

Willingness to pay for earthquake insurance for rural houses and its influencing factors in Xinjiang, China

Enhancing the willingness to pay (WTP) for earthquake insurance for rural houses (EIRH) and transferring earthquake risk is extremely important, especially in the Xinjiang Uygur Autonomous Region (Xinjiang), China, where earthquake disasters frequently occur. Despite the frequent occurrence of such disasters, there is a prevalent low WTP among farmers in Xinjiang. Our research objective was to reveal the reasons of this phenomenon. We explored the intricate relationships between factors that shape the WTP, delving into the perspectives of key stakeholders, including farming households, and the government. This study employed a mixed-methods approach that combines quantitative and qualitative data with binary regression analysis and the control variable approach. The findings indicate that: (1) Willingness to pay is positively correlated with farmers' education level, and it is higher for farmers with poor disaster resistance (aged 40–49 or with incomes below 30,000 RMB). (2) Earthquake risk awareness reveals a positive correlation with WTP, while worry and experience show negative correlations with WTP. (3) The surveyed farming households recognize EIRH as a risk transfer mechanism but heavily rely on government assistance. (4) Notably, an increase in WTP is prominent when government subsidies range from 70% to 90%. (5) Farmers' weak risk awareness, marked by ignorance and distrust of EIRH, calls for strategic interventions. Thus, we recommend that Xinjiang can promote EIRH by adjusting the proportion of subsidies and strengthening the dissemination of disaster risk knowledge.

Apple farmer’s willingness to pay for RWBCIS: Determinants and empirical evidences from Jammu and Kashmir, India

Climate-induced extreme events are increasingly affecting farmers’ livelihoods through weather-related losses such as flash floods, hailstorms, and rising temperatures. In response to these challenges, the Central Government has introduced the voluntary Restructured Weather Based Crop Insurance Scheme (RWBCIS) as an effective risk management strategy. Under this scheme, farmers are required to pay a premium of 5 percent of the total compensation to avail the benefits. Apple, a major commercial crop in the north-western Himalayas, contributes 70 percent of India’s total apple production, with a significant share attributed to the Jammu and Kashmir Union Territory. This study aims to explore whether apple growers are willing to pay for RWBCIS and to identify the drivers influencing their decision to purchase such insurance products. Data were collected from 900 apple growers in the purposively selected districts of Baramulla and Budgam in Jammu and Kashmir. The findings indicate that while all farmers were willing to adopt the weather-based crop insurance scheme, the majority were unwilling to pay the current premium. The estimated mean willingness to pay (WTP) was Rs. 37.22 per tree without covariates and Rs. 17 with covariates, compared to the prevailing Rs. 53 in the neighboring state of Himachal Pradesh. Factors contributing to the low WTP included a lack of knowledge about the scheme’s modalities, basis risk, and distrust in both government and private insurance companies. The government should consider innovative methods to provide existing subsidies to achieve the targeted coverage of 25 percent of farmers under the scheme.

Willingness to Pay for Telemedicine Services Among Uninsured Individuals in Saudi Arabia: A Cross-Sectional Survey.

This study aimed to explore the Willingness To Pay (WTP) of uninsured individuals in Saudi Arabia and the factors influencing their decisions regarding telemedicine services. This study used a cross-sectional survey design and convenience sampling to gather data from respondents aged 18 years or older who had visited healthcare facilities at least once in the past year and were uninsured. WTP was determined using the contingent valuation method, and a two-part regression model was applied to analyze the factors influencing WTP. The study included 4232 participants and discovered that approximately 17.41% were willing to pay for telemedicine services. Those aged 60 and older, employed in the government or private sector, in higher socioeconomic quintiles, and experiencing chronic health issues showed a positive association with their WTP value. Conversely, individuals aged between 30 and 44 years, married, and unemployed exhibited a negative association with a lower WTP value. The findings indicate that most respondents hesitated to pay for telemedicine services, with a significant influence from sociodemographic characteristics, underscoring the need to promote telemedicine use among underserved populations and address health disparities.

Show and tell: farmer field days and learning about inputs with heterogeneous yield effects

Abstract Organic inputs can be effective in reversing soil degradation and improving crop yields, but are often underused in a developing country context. This study seeks to determine whether farmer field days (FFDs) are effective in disseminating information about novel organic inputs, and the extent to which they increase demand for these products. Using experimental auctions to measure willingness to pay (WTP) among smallholder farmers in Western Kenya, we find that those farmers exposed to information from FFDs related to biochar and vermicompost, novel organic inputs, have lower WTP for the products. We present evidence that this is likely driven by two factors in particular: changes in perceptions of input profitability and heterogeneity in yields across demonstration plots within field day sites.

COST-EFFECTIVENESS OF COMBINATION ANTI-CANCER DRUG THERAPY IN THE MANAGEMENT OF HER2-POSITIVE BREAST CANCER: A META-ANALYSIS

Objective: The objective of this review article is to conduct a basic meta-analysis to determine the cost-effectiveness of the trastuzumab, pertuzumab, and docetaxel (THP) combination compared to the trastuzumab and docetaxel (TH) alone in the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients. The analysis aims to measure the costs involved and the health outcomes of the therapy to identify the most cost-effective treatment option. Methods: The researchers collected costs and quality-adjusted life years data from studies that investigated the cost-effectiveness of different treatment regimens for HER2-positive breast cancer. A meta-analysis was conducted using these data, and a probabilistic sensitivity analysis with 1000 iterations was performed using an Excel spreadsheet. The input data used in the analysis were obtained from four studies deemed appropriate for the meta-analysis. Results: The outputs obtained from the meta-analysis were plotted on an incremental cost-effectiveness ratio (ICER) scatterplot. The ICER scatter plots of the four studies showed that the THP combination was 0% cost-effective at a willingness to pay (WTP) threshold of I$100,000/QALY and 2.38% cost-effective at a WTP of I$200,000/QALY. However, at a higher WTP of I$500,000/QALY, the THP combination was found to be 52.8% cost-effective compared to the TH combination. Conclusion: Based on the findings of this meta-analysis, the THP combination treatment for HER2-positive breast cancer patients is cost-effective compared to the TH combination at a willingness to pay threshold of I$500,000/QALY. However, at lower WTP thresholds, the THP combination may not be cost-effective. These results provide valuable insights for prescribers in identifying and selecting the most cost-effective treatment option among the alternatives available for HER2-positive breast cancer patients.

Detecting Mother-Father Differences in Spending on Children: A New Approach Using Willingness-to-Pay Elicitation

This paper tests whether mothers and fathers differ in their spending on daughters relative to sons by comparing their willingness to pay (WTP) for specific goods for their children. This method, which we apply in Uganda, offers more precision than the standard method of examining expenditure effects of mothers’ versus fathers’ income. We find that fathers have a lower WTP for their daughters’ than their sons’ human capital but mothers do not. Altruism plays a role: fathers’ but not mothers’ WTP for goods that simply bring joy to their daughters is lower than their WTP for such goods for sons. (JEL D64, G51, J12, J13, J16, O12)