Valuation Studies Research Articles

Valuing Banyumas Cultural Heritage Tourism: A Comparative Analysis in Support of SDG’s 11 for Sustainable Cities and Communities

The study of the economic valuation of cultural heritage tourism has a long history and has gained renewed interest in recent years. This paper poses a methodological challenge in using alternative scales to monetary ranges for cultural heritage valuation. A famous Banyumas cultural tourism site is taken as a case study, and the site's utility is estimated through the method of travel cost (monetary value) and time spent visiting the site (non-monetary scale). According to consumption theory, this study finds an inverse relationship between the two scales and demand intensity. While the monetary approach mainly reflects the cost of accessing cultural heritage tourism – ceteris paribus preference– the time spent approach shows that those who invest more time in the visit are fanatics, avid enthusiasts, fascinated visitors, engagement visitors, and educated adults. These results provide more efficient policy implications in cultural tourism management and market valuation. This aligns with Sustainable Development Goal (SDG) 11's objectives, which encourage making cities and human settlements inclusive, safe, resilient, and sustainable. By evaluating cultural heritage through monetary and non-monetary methods, this study supports the development of tourism policies that enhance visitor satisfaction and prioritise the sustainable management and preservation of cultural sites for future generations.

Cancer-specific utility instrument for health economic evaluations: A synopsis of the EORTC QLU-C10D user manual and current validity evidence.

The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility - Core 10 Dimensions (QLU-C10D) adds a preference-based scoring algorithm to the EORTC measurement portfolio. It is built on the most widely used health-related quality of life (HRQoL) measure in oncology, the EORTC Quality of Life Questionnaire - Core 30 (QLQ-C30), allowing for the calculation of both HRQoL profiles and health utilities. This is an important advancement for integrating cancer-specific values into health economic evaluations and decision making, offering greater content validity and statistical power than some generic measures. This article presents an outline of the EORTC QLU-C10D User Manual to inform health-technology bodies, academic researchers, and industry, on the why and how of using this instrument for utility measurement. It covers basic concepts, proper use of the tool, including administration and scoring. Further, we summarise the presently published valuation studies, country-specific value sets, and body of evidence about psychometric properties. Current methodological questions are discussed, including mapping between utility measures and adaptions of generic measures for use in cancer populations. Taking into account empirical studies on psychometric properties, like content and construct validity, and comparisons with generic measures, we argue that the QLU-C10D is a reliable and valid instrument for cancer populations. Without imposing additional patient and administrative burden it has the potential to support health economic decisions in cancer by providing high-quality cancer-specific utility scores, to complement the more detailed HRQoL information from the QLQ-C30.

The willingness to pay for healthcare at time of crisis: a contingent valuation study among Saudi individuals

ABSTRACT Background and aims COVID-19 put healthcare systems around the world under significant pressure, and led to a global recession. In response, governments implemented aid programmes to stimulate their economies. This, along with the outbreak of war in Ukraine, complicated the economic situation. All of this may have ramifications on people’s access to essential healthcare services. This study aims to investigate the willingness to pay for healthcare among Saudi individuals at time of economic downturn. Methods Questionnaires were used to collect data from 600 individuals across six provinces of Riyadh City between December 2017 and January 2018. The data were elicited using a closed ended format. A probit regression and marginal effects analyses were used to analyze the data. Results and conclusion The results showed just over half the sample were willing to pay, suggesting that countries should give careful consideration to whether and when to involve people in financing healthcare services at time of economic turmoil. The results could be used by policymakers in decisions around funding allocation and priority setting.

A crypto way out: cryptocurrency, techno-economic imaginaries, and crisis in Russia

ABSTRACT Russia is a global forerunner in cryptocurrency adoption. This paper explores how cryptocurrency, as a techno-economic actant, informs the way Russians strategize their lives and imagine alternative futures. Based on in-depth interviews with Russian cryptocurrency owners and advocates (N = 21), we show how this new digital asset is tied to specific techno-economic imaginaries, allowing Russians to envision shortcuts out of prolonged crises. By mobilizing concepts from science and technology studies, sociology of crises, and the study of economic valuation, we unpack how cryptocurrency has a performative effect (i.e. acts and makes act) on the way Russians live during crises. The analysis reveals three shortcuts on different social levels. First, on a day-to-day level, cryptocurrency is imagined as a way to hedge against inflation, circumvent payment restrictions, and find alternative sources of income. Second, it acquires political value as it is seen as a means to circumvent state power through self-custody of value and anonymity. Finally, engagement with cryptocurrency fosters a belief in an alternative geofinancial configuration, envisioning the replacement of the US Dollar as the global currency and imagining a post-state tech utopia.

Sleep Value and Sleep Resilience are Important Dimensions of Sleep Health and We Measured Them: Methods for the Sleep Resilience and Variance in Sleep Valuation (SRVIV) Study

Abstract Sleep health is a multidimensional construct that is essential for general health and well-being. Sleep value, the amount of worth an individual places on their sleep, and sleep resilience, the ability to function emotionally, cognitively, and physically in the presence of sleep disturbances are overlooked dimensions of sleep health. To study these sleep health dimensions, we developed the Sleep Valuation Item Bank 2.0, Values Inventory, Monetary Sleep Value Questionnaire, and Sleep Resilience Questionnaire. This paper describes the methods for the Sleep Resilience and Variance in Sleep Valuation (SRVIV) Study. The SRVIV study was conducted to explore the factor structure of sleep value and sleep resilience and determine how they relate to demographic, sleep, and psychological variables. This study resulted in an analysis sample of 455 participants who were recruited by a Qualtrics team and completed a Qualtrics survey consisting of demographic, anxiety, depression, and sleep-related questionnaires, in addition to sleep value and sleep resilience questionnaires. Adult participants were recruited throughout the continental United States and were predominately female (53%), white (82%), married (50%), and had an average age of 45.4 years. The data resulting from this study can be used to address important questions in the field of sleep psychology.

Whose values? From the discrete to the continuous in how place and space matter in valuation studies

This collection provides some invaluable insight on the interface between the academic discipline of Geography and studies of values and valuation. This article suggests that the tension between the normative and the analytical dimensions of these terms in man pieces is best rooted in the subdiscipline of economic sociology associated with scholars such as Boltanski and Thevenot, Mackenzie, Muniesa and Stark. It goes on to highlight how the geographical tradition might be best served by developing less an argument about why ‘space matters’ and more the sense in which affordances and propensities invoke the temporal and the spatial simultaneously, a framing that echoes Latour’s characterisation of ‘timespace’. This argument is illustrated with reference to the notion of urban fabric as an exemplar of what Latour characterises as the ‘fifth dimension’.

PCR43 Who Prefers Death to Life in Composite Time Trade-Off Interviews and Why: A Mixed-Methods Analysis of the Singapore EQ-5D-5L Valuation Study

PCR43 Who Prefers Death to Life in Composite Time Trade-Off Interviews and Why: A Mixed-Methods Analysis of the Singapore EQ-5D-5L Valuation Study

PCR154 SF-6Dv2 Valuation Study in South Korea: Uncovering Level Inconsistencies and Next Steps for Research

PCR154 SF-6Dv2 Valuation Study in South Korea: Uncovering Level Inconsistencies and Next Steps for Research

Cost-Benefit Appraisal of Universal Design in Public Transport and Walking/Cycling Infrastructure.

Public budgets are limited and priorities must be made between competing projects. Cost-benefit analysis (CBA) is the standard tool to assess projects and prioritise between them, as is done, e.g., in national transport plans. Universal design (UD) is typically a legal requirement in new investments and their benefits and contribution in CBA have usually not received much attention. Therefore, there is a risk that benefits are underestimated in projects that include UD elements and that these projects are subsequently ranked lower than what they ought to according to CBA performance. In this paper, we develop a user-friendly methodology for CBA of UD projects in public transport and walk/cycle infrastructure which aligns with national handbooks and guidelines for project appraisal. It contains five core elements: 1. User benefit. User benefit stems from valuation studies and are summarized and discounted over an assessment period, which in Norway is 40 years. This includes annual real price adjustments and the use of a discount rate according to guidelines. 2. Non-user effects. The degree to which UD projects affect other travellers, this (dis)benefit is accounted for. 3. Costs. Budget costs include investment and possible reinvestment at the end of economic life and annual operation and maintenance costs. These are summarized and discounted over the analysis period. Residual value after 40 years is subtracted. 4. Demand. Increases in walking and cycling have health benefits. Moreover, demand diverted from motorized transport and car to public transport, walking and cycling will affect external costs of road congestion, emissions, and accidents. 5. Shadow prices. According to Norwegian practice, the use of public funds has an inefficiency cost. Therefore, we add a shadow price on money from the public purse. With worked examples, we demonstrate that UD projects in transport are indeed available for CBA appraisal. What is more, they compete surprisingly well with alternative uses of public budgets. In fact, UD projects outperform most other transport projects in Norway when considering their cost-benefit performance. Money spent on UD gives more welfare back to society than most other uses within the transport sector. This means that UD need not only be a legal requirement in new installations. UD can also compete with, and be prioritized over, other transport investments and projects.

Perception of health workers and assessment of tree spp. Composition in adeoyo general hospital, ibadan, oyo state

Trees as a crucial component of forest play a vital role in providing a wide range of products and services including health benefits. The lack of information on tree species composition and diversity around public health care facilities in Ibadan may hinder comprehensive understanding of the ecological value and potential benefits that trees provide to the surrounding environment and public health care facilities. This study assessed the perceptions of health workers and evaluation of trees within the premises of Adeoyo General Hospital, Ibadan. Forty-nine (49) Structured questionnaire was used to derive the perceptions, while total enumeration of all the trees with diameter at breast height (DBH) greater than or equal to 10 cm were identified and enumerated in the study area. Tables and percentages were used to analyze the perception of the health workers while data collected on dbh (cm) and total height (m) were used to compute basal area (m2) and volume (m3). The analysis of socio-demographic data revealed a higher representation of female health workers (61.2%), a concentration of professionals in the 30 to 39 age group (46.9%), and a predominant presence of married individuals with tertiary education. Examining health workers' perceptions, a significant consensus emerges on the positive effects of tree exposure. Workers believed that exposure to trees improve patient clinical outcomes, speeds up recovery, and boosts the immune system (42.9%). There is also recognition of the role of trees in reducing stress levels and enhancing focus for both patients and healthcare workers. The positive correlation between trees around healthcare facilities and increased staff satisfaction is noteworthy. In the study area, Azadirachta indica was the dominant tree species constituting 42.2% of the total population. Terminalia catappa and Gliricidia sepium are also of great significance. Mean diameter, height, basal area, and volume suggest a diverse forest with a wide range of tree sizes. Meliaceae dominated the families with 42.2% while other families like Fabaceae and Combretaceae also contributed to biodiversity and ecological significance. In DBH, Delonix regia had the highest value of 198.3cm while Newbouldia laevis had 15.1 cm as the lowest value. Antiaris africana and Azadirachta indica both had the maximum values of 19.8 m and 51.8 m3 in height and basal area respectively. Species diversity indices indicated a diverse forest ecosystem with 13 identified taxa and 64 individuals. The diversity index (Shannon-Wienner) of 1.89 - though it is low- is within the general limit for tropical forests. It is therefore recommended that integration and management of green spaces in healthcare facility design, development of employee wellness programs, promoting nature exposure, educational initiatives on the benefits of nature and economic valuation studies should be greatly considered.

Large scale OECD health valuation study to estimate the economic benefits of chemical regulation

Abstract Chemical regulation aims at protecting human health and the environment from the risks of chemicals, while recognizing the economic importance of the use of chemicals. Assessment of the societal impacts of chemical regulation and different policy options requires information on both costs and benefits. So far, regulators assessing chemicals regulations has not had access to high quality and internationally comparable data on the full monetary benefit of reducing health and environmental risk. The OECD has implemented a multi-country stated preference valuation project that covers ten chemicals-related health conditions (e.g. asthma, kidney disease, infertility, etc.) with more than 80 surveys with large samples in 22 countries. The OECD Surveys on Willingness-to-Pay to Avoid Negative Chemicals-Related Health Impacts (SWACHE) project aims to establish internationally comparable values for the willingness-to-pay (WTP) to avoid negative health effects due to exposure to chemicals. The values can be used to demonstrate and measure the economic benefits of minimising the morbidity impacts of chemical regulations, environmental policies and public policies in general. The latest valuation results of the project will be presented, along with key aspects of the joint methodology used and the plans to further expand this work. In addition, the OECD is collaborating with other intergovernmental organisations via the Inter-Organization Programme for the Sound Management of Chemicals (IOMC) to update the cost of inaction estimates for chemicals as part of the Global Framework on Chemicals. An update on this initiative, that can benefit from the results of the SWACHE project, will be provided.

Health-related quality of life of people with depression: pre-post intervention compared with age-matched general population in Vietnam

BackgroundIn Vietnam, there is a paucity of health-related quality of life (HRQoL) research on people with depression as well as a lack of evidence on supported self-management (SSM) intervention for depression on HRQoL. This study aimed to compare the HRQoL of people with depression and age-matched people in the Vietnamese population, evaluate the effects of Tele-SSM intervention on HRQoL, and examine the association between the changes in HRQoL score and mental health well-being (depression, anxiety, and stress).MethodsThis study was a pre- and post-study involving Vietnamese adults aged 18–64 who had depression symptoms (score ≥ 5 points in the PHQ-9). Participants (N = 58) completed Tele-SSM—a supported self-management intervention incorporating cognitive behavioral therapy and non-violent communication and using a task-shifting approach. To compare with the general population, we conducted a 1-to-1 matching by age with an EQ-5D-5L valuation study with a nationally representative sample of the Vietnamese general population.ResultsHRQoL was significantly impaired in people with depression compared to the age-matched general population. Regarding health profile, participants reported the most difficulties in usual activities, pain/discomfort, and anxiety/depression dimensions. Significant improvements were observed in HRQoL scores post-intervention compared to pre-intervention in both EQ-VAS scores (from 59.84 to 79.48) and utility scores (from 0.79 to 0.90). These results remained lower than the age-matched general population (EQ-VAS score = 83.28, utility score = 0.96). Depression was associated with lower HRQoL while controlling for stress, anxiety symptoms and sociodemographic characteristics.ConclusionsThese results indicate that HRQoL is significantly impaired in people with depression and contribute to providing empirical evidence of Tele-SSM intervention in improving HRQoL. Further randomized controlled trials should be conducted to evaluate the effectiveness and cost-effectiveness of the Tele-SSM intervention.

A Contingent Valuation Study for Use in Valuing Public Goods with Health Externalities: The Case of Street Pianos.

Clinical healthcare is not the only way to improve an individual's health. Community-based interventions can have health and wellbeing impacts as well; however, the nature of these interventions, which have public good characteristics, poses challenges for the typical ways in which we value outcomes for use in (health) economic evaluations. The approaches to valuation of these type of interventions should allow for the incorporation of all types of values including option value, externalities and individual use-value. This is a feasibility study with the objective to re-consider the importance of health externalities when valuing public health interventions that are treated as public goods from an economic perspective. A contingent valuation (CV) survey was designed to elicit individual willingness to pay (WTP) for the public piano programme (PPP). Five different scenarios were designed; three scenarios focussed on individual use-value, while the other two (scenarios 4 and 5) covered option values and externalities. An online survey was conducted with a sample of 105 people. Preferences differed across the different scenarios. The mean WTP for scenario 1 was £0.81, for scenario 2 £3.65, for scenario 3 £3.07, for scenario 4 £7.26 and for scenario 5 £6.02. The WTP results for each scenario are presented and discussed regarding the nature of the good, user and non-user perspectives, payment vehicles and individual characteristics. This study provides evidence that all types of use are necessary for inclusion in an economic evaluation, especially when the good in question is a public good where its benefits can be obtained from all community members.

Anatomical Depiction: How Showing a Product's Inner Structure Shapes Product Valuations

Anatomical depiction is a technique whereby the product is decomposed into components that are spatially arranged layer by layer to visually explicate its inner structure. The authors demonstrate that anatomical depiction, compared with nonanatomical depiction, enhances product valuation. This effect occurs because anatomical depiction elicits a “coming together” of the inner components in consumers’ minds, thereby evoking a gestalt image of the product—a process labeled “simulated assemblage.” The elicitation of simulated assemblage in turn boosts confidence in the product's performance. Two field experiments demonstrate that anatomical depiction leads to greater engagement in online settings such as peer-to-peer selling and social media advertising. Subsequently, seven laboratory and online experiments show when and how anatomical depiction elicits simulated assemblage (Studies 1a–c), test the process underlying the effect of anatomical depiction on product valuation (Studies 2a–b), and delineate two boundary conditions, showing that the positive effect of anatomical (vs. nonanatomical) depiction attenuates for consumers higher (vs. lower) in technology anxiety (Study 3) and when consumers have a hedonic (vs. utilitarian) consumption goal (Study 4). Collectively, this work provides insights to firms on how and when to use anatomical depiction to enhance consumers’ confidence in and valuation of the product.

Health State Utilities Associated With Treatment Burden in Cystic Fibrosis: A Patient Valuation Study

BACKGROUNDWhile recent advancements in the treatment of cystic fibrosis (CF) have improved survival, reducing high levels of treatment burden remains a priority issue for many people with CF (pwCF). However, economic evaluations of novel interventions may fail to capture their impact on treatment burden due to a lack of suitable outcome measures. This study aimed to estimate health state utilities (HSUs), for changes in treatment burden associated with different CF treatments. RESEARCH QUESTIONWhat value do pwCF place on changes in treatment burden associated with intravenous antibiotic treatment of pulmonary exacerbations, inhaled medicines, and physiotherapy? STUDY DESIGNAND METHODS: Adults attending a specialist CF center were invited to participate in a web-based time trade-off interview. Participants valued their own health, and five health state vignettes describing varying levels of intensity of physiotherapy, inhaled, and IV antibiotic treatment. HSUs for additional instances of each treatment type were estimated using mixed effect linear regression models. RESULTSFifty one people with CF completed the interview (median age, 30 years; range, 19-66); 53% were female; mean FEV(1) % predicted, 65% [SD, 20%]).Mean utility scores for own health were very similar between the EQ-5D index value (0.81, SD 0.20) and the TTO value (0.82, SD 0.20), however limited concordance was observed at the individual level. Adjusted utility decrements associated with treatment burden were -0.037 (SE 0.008) for an additional annual IV antibiotic treatment, -0.029 (SE 0.014) for an additional daily physiotherapy session, and -0.019 (SE 0.013) for an additional daily inhaled medicine. INTERPRETATIONIncreasing treatment burden was associated with decreasing HSU values. The utility decrements associated with treatment burden changes suggest meaningful differences in health-related quality of life (HRQoL) for pwCF. These findings align with existing literature on the impact of treatment burden on HRQoL, and highlight the importance of considering treatment burden in economic evaluations of interventions in CF.

A choice experiment economic valuation of cultural heritage tourism ecosystems

Economic valuation studies of non-market goods in culture and tourism have a long and recognised track record. Many studies focus on evaluating well-defined examples such as monuments, institutions or events, leaving the valuation of cultural heritage tourism ecosystems as an important and less explored challenge. This work addresses the evaluation of a cultural tourist ensemble in which factors such as the natural landscape, elements of tangible historical heritage and intangible technological knowledge are integrated, all referring to a specific territorial demarcation, which acts as a driver of tourist appeal. Choice experiment methodology is applied to obtain the value allocated to different attributes of the ensemble by various groups of visitors, according to their origin or type of stay: first, local, national and foreign visitors; and second, the canonical distinction between excursionists and tourists. In general, locals report a greater contribution to preserve cultural expressions while nationals and foreigners do so for tourism services. Tourists report greater appreciation for cultural consumption while excursionists do so for drivers of cultural and territorial brand. Our approach and results can provide a better basis to implement strategies of management and preservation of cultural ecosystems as niches for tourism activity and economic impact.

Estimating the Health-Related Quality of Life Benefit of Prophylactic Treatment for COVID-19 in Immunocompromised People: A Multimethod Valuation Study.

Background: Pre-exposure prophylaxis (PrEP) for COVID-19 provides additional protection, beyond vaccines alone, for individuals who are immunocompromised (IC). This may reduce the need for preventative behavioral modification, such as shielding-a behavioral restriction limiting an IC individual to minimize face-to-face interactions and/or crowded places. Therefore, PrEP may improve psychosocial well-being and health-related quality of life (HRQoL) for individuals with IC conditions. Objective: To estimate the potential HRQoL and utility benefit of PrEP for prevention of COVID-19 in individuals with IC conditions who may not have an adequate response of full vaccination (and therefore are at "highest risk" of severe COVID-19) that can be used in future economic evaluations of preventative therapies against COVID-19. Methods: Vignettes describing HRQoL associated with 2 pre-PrEP states (shielding and semi-shielding behavioral restrictions) and a post-PrEP state were developed from a literature review and tested through interviews with clinicians (n = 4) and individuals with IC conditions (n = 10). Vignettes were valued by a general population sample (N = 100) using a visual analog scale (VAS), time trade-off (TTO), and EQ-5D-5L. A sample of individuals with IC conditions (n = 48) valued their current HRQoL and a post-PrEP vignette using VAS and EQ-5D-5L. Results: Individuals with IC conditions reported a mean current EQ-5D-5L score of 0.574, and 0.656 for post-PrEP based on the vignette. PrEP would lead to behavior changes for 75% (30/40) of individuals with IC conditions and an emotional benefit for 93% (37/40) of individuals with IC conditions. Mean values from the general population valuation based on EQ-5D-5L ranged from 0.606 ("shielding") to 0.932 ("post-PrEP"). Conclusion: This study quantified the expected health state utility benefit of reduced psychosocial burden and behavioral restriction. PrEP would potentially result in a utility gain between 0.082 and 0.326, dependent on valuation approach and expected change in behavioral restrictions, leading to improvements in daily activities and emotional well-being.

The Performance of Kaizen Tasks Across Three Online Discrete Choice Experiment Surveys: An Evidence Synthesis.

Kaizen is a Japanese term for continuous improvement (kai ~ change, zen ~ good). In a kaizen task, a respondent makes sequential choices to improve an object's profile, revealing a preference path. Including kaizen tasks in a discrete choice experiment has the advantage of collecting greater preference evidence than pick-one tasks, such as paired comparisons. OBJECTIVE ANDMETHODS: So far, three online discrete choice experiments have included kaizen tasks: the 2020 US COVID-19 vaccination (CVP) study, the 2021 UK Children's Surgery Outcome Reporting (CSOR) study, and the 2023 US EQ-5D-Y-3L valuation (Y-3L) study. In this evidence synthesis, we describe the performance of the kaizen tasks in terms of response behaviors, conditional logit and Zermelo-Bradley-Terry (ZBT) estimates, and their standard errors in each of the surveys. Comparing the CVP and Y-3L, including hold-outs (i.e., attributes shared by all alternatives) seems to reduce positional behavior by half. The CVP tasks excluded multi-level improvements; therefore, we could not estimate logit main effects directly. In the CSOR, only 12 of the 21 logit estimates are significantly positive (p < 0.05), possibly due to the fixed attribute order. All Y-3L estimates are significantly positive, and their predictions are highly correlated (Pearson: logit 0.802, ZBT 0.882) and strongly agree (Lin: logit 0.744, ZBT 0.852) with the paired-comparison probabilities. These discrete choice experiments offer important lessons for future studies: (1) include warm-up tasks, hold-outs, and multi-level improvements; (2) randomize the attribute order (i.e., up-down) at the respondent level; and (3) recruit smaller samples of respondents than traditional discrete choice experiments with only pick-one tasks.

Assessing farmers’ willingness to pay for FMD vaccines and factors influencing payment: a contingent valuation study in central Oromia, Ethiopia

BackgroundFoot and mouth disease is a contagious, transboundary, and economically devastating viral disease of cloven-hoofed animals. The disease can cause many consequences, including decreased productivity, limited market access, and elimination of flocks or herds. This study aimed to assess farmers’ willingness to pay (WTP) for foot and mouth disease (FMD) vaccines and identify factors influencing their WTP. A cross-sectional questionnaire survey was conducted on 396 randomly selected livestock-owning farmers from three districts in the central Oromia region (Ambo, Dendi, and Holeta districts. The study utilized the contingent valuation method, specifically employing dichotomous choice bids with double bounds, to evaluate the willingness to pay (WTP) for the FMD vaccine. Mean WTP was assessed using interval regression, and influential factors were identified.ResultsThe study revealed that the farmer’s mean willingness to pay for a hypothetical foot and mouth disease vaccine was 37.5 Ethiopian Birr (ETB) [95% confidence interval [CI]: 34.5 40.58] in all data, while it was 23.84 (95% CI: 21.47–26.28) in the mixed farming system and 64.87 Ethiopian Birr (95% CI: 58.68 71.15) in the market-oriented farming system. We identified main livelihood, management system, sales income, breed, keeping animals for profit, and foot and mouth disease impact perception score as significant variables (p ≤ 0.05) determining the farmers’ WTP for the FMD vaccine.ConclusionFarmers demonstrated a high computed willingness to pay, which can be considered an advantage in the foot and mouth disease vaccination program in central Oromia. Therefore, it is necessary to ensure sufficient vaccine supply services to meet the high demand revealed.

Scale and rate heterogeneity in the EQ-5D-5L valuation

ObjectivesTo estimate values on a quality-adjusted life year (QALY) scale using individual preference evidence, choice analyses typically include ancillary parameters, such as scale factors and discount rates. These parameters potentially differ among respondents. In this study, we investigated how allowing heterogeneity in scale and rate affects the estimation of EQ-5D-5L values.MethodsUsing the first wave of the 2016 EQ-5D-5L valuation study (N = 1017), we estimated a conditional logit (CL) model and three mixed logit models: random scale, random rate, and bivariate. Prior to the exploratory study, we hypothesized that scale and rate are correlated and that allowing heterogeneity in both parameters decreases the number of insignificant incremental effects. We confirmed the exploratory findings by re-estimating these models using paired comparison responses from a second wave (N = 1229).ResultsScale and rate exhibited significant heterogeneity and were positively correlated. As hypothesized, allowing this heterogeneity improved the face validity of the EQ-5D-5L value set by reducing the number of insignificant incremental effects (from 6 to 2 p-values > 0.05; out of 20). Nevertheless, the CL and bivariate mixed logit estimates are highly correlated and concordant (Pearson correlation coefficient of 0.897, Spearman correlation coefficient of 0.888, Lin’s concordance coefficient of 0.763).ConclusionsAllowing this heterogeneity adds three parameters to the estimation (two variances and a correlation) and improves the face validity of the EQ-5D-5L values. This finding may influence experimental design and choice analysis in health valuation more generally.