Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-20T02:46:34.472Z Has data issue: false hasContentIssue false

Contingent valuation: what needs to be done?

Published online by Cambridge University Press:  01 January 2010

Richard D. Smith*
Affiliation:
Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Tracey H. Sach
Affiliation:
School of Chemical Sciences and Pharmacy and Health Economics Group, University of East Anglia, Norwich, UK
*
Correspondence to: Richard D. Smith, Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: [email protected]

Abstract

Contingent valuation (CV) has been argued to have theoretical advantages over other approaches for benefit valuation used by health economists. Yet, in reality, the technique appears not to have realised these advantages when applied to health-care issues, such that its influence in decision-making at national levels has been non-existent within the health sector. This is not a result of a lack of methodological work in the area, which has continued to flourish. Rather, it is a result of such activities being undertaken in a rather uncoordinated and unsystematic fashion, leading CV to be akin to a ‘ship without a sail’. This paper utilises a systematic review of the CV literature in health to illustrate some important points concerning the conduct of CV studies, before providing a comment on what the remaining policy and research priorities are for the technique, and proposing a guideline for such studies. It is hoped that this will initiate some wider and rigorous debate on the future of the CV technique in order to make it seaworthy, give it direction and provide the right momentum.

Type
Debate
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acton, J. P. (1973), Evaluating Public Programs to Save Lives: The Case of Heart Attacks, Santa Monica: R-950-RC, RAND.Google Scholar
Acton, J. P. (1976), ‘Measuring the monetary value of lifesaving programs’, Law and Contemporary Problems, 40: 4672.CrossRefGoogle Scholar
Adler, M. D. (2006), ‘QALYs and policy evaluation: a new perspective’, Yale Journal of Health Policy, Law and Ethics, VI: 192.Google Scholar
Arrow, K., Solow, R., Portney, P. R., Leamer, E. E., Radner, R.Schuman, H. (1993), ‘Report of the NOAA panel of contingent valuation’, Federal Register, 58: 46014614.Google Scholar
Bateman, I., Carson, R. T., Day, B., Hanemann, W. M., Hanley, N., Hett, T., Jones, A., Loomes, G., Mourato, S., Ozdemiroglu, E., Pearce, D. W., Sugden, R.Swanson, J. (2002), Economic Valuation with Stated Preferences Techniques. A Manual, Cheltenham: Edward Elgar.CrossRefGoogle Scholar
Bleichrodt, H.Quiggin, J. (1999), ‘Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost–benefit analysis?’, Journal of Health Economics, 18(6): 681708.CrossRefGoogle ScholarPubMed
Buxton, M. J. (2005), ‘How much are health-care systems prepared to pay to produce a QALY?’, European Journal of Health Economics, 6: 285287.CrossRefGoogle ScholarPubMed
Byrne, M. M., O’malley, K.Suarez-Almazor, M. E. (2005), ‘Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis’, Medical Decision Making, 25: 655666.CrossRefGoogle Scholar
Cookson, R. (2003), ‘Willingness to pay methods in health care: a sceptical view’, Health Economics, 12: 891894.CrossRefGoogle Scholar
Covey, J.Smith, R. D. (2006), ‘How common is the “prominence effect”? Additional evidence to Whynes et al., Health Economics, 15: 205210.CrossRefGoogle ScholarPubMed
Devlin, N.Parkin, D. (2004), ‘Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis, Health Economics, 13: 437452.CrossRefGoogle ScholarPubMed
Diener, A., O’Brien, B.Gafni, A. (1998), ‘Health care contingent valuation studies: a review and classification of the literature’, Health Economics, 7: 313326.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Dolan, P.Edlin, R. (2002), ‘Is it really possible to build a bridge between cost–benefit analysis and cost-effectiveness analysis?’, Journal of Health Economics, 21: 827843.CrossRefGoogle ScholarPubMed
Donaldson, C., Bateman, I., Chilton, S., Jones-Lee, M., Loomes, G., Metcalf, H., Mugford, M., Robinson, A., Ryan, M., Shackley, P., Smith, R. D., Sugden, R.Wildman, J. (2003), What is the Value to Society of a QALY?, Department of Health. NCCRD, Birmingham, UK.Google Scholar
Donaldson, C., Brouwer, W., Gulacsi, L., Gyrd-Hansen, D., Kozierkiewicz, A., Olsen, J. A., Manca, A., Mataria, A., Moatti, J. P., Persson, U., Pinto Prades, J. L., Ryan, M.Smith, R. D. (2006), ‘European Value of a Quality Adjusted Life Year’, European Union Framework, 6. http://cordis.europa.eu/fetch?CALLER=FP6_PROJ&ACTION=D&DOC=1&CAT=PROJ&QUERY=0121eaa95d53:22fc:1d7ece4e&RCN=84063Google Scholar
Drummond, M., Weatherly, H., Claxton, K., Cookson, R., Ferguson, B., Godfrey, C., Rice, N., Sculpher, M., Sowden, A. (2007), Assessing the Challenges of Applying Standard Methods of Economic Evaluation to Public Health Interventions. http://www.york.ac.uk/phrc/D1-05_FR.pdf [3 April 2008].Google Scholar
Eichler, H. G., Kong, S. X., Gert, W. C., Mavros, P.Jonsson, B. (2004), ‘Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge?’, Value in Health, 7: 518528.CrossRefGoogle ScholarPubMed
Franica, D. M., Pathakb, D. S.Gafni, A. (2005), ‘Quality-adjusted life years was a poor predictor of women’s willingness to pay in acute and chronic conditions: results of a survey’, Journal of Clinical Epidemiology, 58: 291303.CrossRefGoogle Scholar
Frew, E. J., Whynes, D. K.Wolstenholme, J. L. (2003), ‘Eliciting willingness to pay: comparing closed-ended with open-ended and payment scale formats’, Medical Decision Making, 23: 150159.CrossRefGoogle ScholarPubMed
Gafni, A.Birch, S. (2006), ‘Incremental cost-effectiveness ratios (ICERs): the silence of the lambda’, Social Science and Medicine, 62: 20912100.CrossRefGoogle ScholarPubMed
Garber, A. M.Phelps, C. E. (1997), ‘Economic foundations of cost-effectiveness analysis’, Journal of Health Economics, 16(1): 131.CrossRefGoogle ScholarPubMed
George, B., Harris, A.Mitchell, A. (2001), ‘Cost-effectiveness analysis and the consistency of decision-making. Evidence from pharmaceutical reimbursement in Australia (1991–1996)’, PharmacoEconomics, 19: 11031109.CrossRefGoogle Scholar
Gyrd-Hansen, D. (2003), ‘Willingness to pay for a QALY’, Health Economics, 12: 10491060.CrossRefGoogle ScholarPubMed
Hammitt, J. K. (2002), ‘How Much is a QALY Worth? Admissible Utility Functions for Health and Wealth’, Working Paper, Harvard Center for Risk Analysis, Harvard University.Google Scholar
Haninger, K., Hammitt, J. K. (2006), ‘Willingness to Pay for Quality Adjusted Life Years: Empirical Inconsistency between Cost-effectiveness Analysis and Economic Welfare Theory’, Working Paper, Harvard Center for Risk Analysis, Harvard University.Google Scholar
Hanley, N., Ryan, M.Wright, R. (2003), ‘Estimating the monetary value of health care: lessons from environmental economics’, Health Economics, 12: 316.CrossRefGoogle ScholarPubMed
Hirth, R. A., Chernew, M. E., Miller, E., Fendrick, A. M.Weissert, W. G. (2000), ‘Willingness to pay for a quality-adjusted life year: in search of a standard’, Medical Decision Making, 20: 332342.CrossRefGoogle ScholarPubMed
Johannesson, M. (1995), ‘The relationship between cost-effectiveness analysis and cost–benefit analysis’, Social Science and Medicine, 41: 483489.CrossRefGoogle ScholarPubMed
Johnson, F. R., Fries, E. E.Banzhaf, H. S. (1997), ‘Valuing morbidity: an integration of the willingness to pay and health status index literature’, Journal of Health Economics, 16: 641665.CrossRefGoogle Scholar
King, J. T., Tsevat, J., Lave, J. R.Roberts, M. S. (2005), ‘Willingness to pay for a quality-adjusted life year: implications for societal health care resource allocation’, Medical Decision Making, 25: 667677.CrossRefGoogle ScholarPubMed
Klose, T. (1999), ‘The contingent valuation method in health care’, Health Policy, 47: 97123.CrossRefGoogle ScholarPubMed
Mitchell, R.Carson, R. (1989), Using surveys to value public goods: The contingent valuation method, Washington, DC: Resources for the Future.Google Scholar
Mooney, G. H. (1986), Economics, Medicine and Health Care, London: Harvester Wheatsheaf.Google Scholar
Mooney, G. H. (1994), Key Issues in Health Economics, New York: Harvester Wheatsheaf.Google Scholar
National Institute of Health and Clinical Excellence (2004), Guide to the Methods of Technology Appraisal. Accessed 1 July 2008. http://www.nice.org.uk/pdf/TAP_Methods.pdfGoogle Scholar
Olsen, J. A.Smith, R. D. (2001), ‘Theory versus practice: A review of “willingness-to-pay” in health and health care’, Health Economics, 10: 3952.3.0.CO;2-E>CrossRefGoogle Scholar
Phelps, C. E.Mushlin, A. I. (1991), ‘On the (near) equivalence of cost-effectiveness and cost–benefit analyses’, International Journal of Technology Assessment in Health Care, 7(1): 1221.CrossRefGoogle ScholarPubMed
Rawlins, M.Culyer, A. (2004), ‘National Institute for Clinical Excellence and its value judgements’, British Medical Journal, 329: 224227.CrossRefGoogle Scholar
Richardson, J.Smith, R. D. (2004), ‘Calculating society’s willingness-to-pay for a QALY: key questions for discussion’, Applied Health Economics and Health Policy, 3(3): 125126.CrossRefGoogle ScholarPubMed
Sach, T., Smith, R. D.Whynes, D. (2007), ‘A “league table” of contingent valuation results for pharmaceutical interventions: a hard pill to swallow?’, PharmacoEconomics, 25: 107127.CrossRefGoogle Scholar
Smith, R. D. (2000), ‘The discrete choice willingness-to-pay question format in Health Economics: should we adopt environmental guidelines?’, Medical Decision Making, 20(2): 194206.CrossRefGoogle ScholarPubMed
Smith, R. D. (2001), ‘The relative sensitivity of willingness-to-pay and time-trade-off to changes in health status: an empirical investigation’, Health Economics, 10: 487497.CrossRefGoogle ScholarPubMed
Smith, R. D. (2003), ‘Construction of the contingent valuation market in health care: a critical assessment’, Health Economics, 12: 609628.CrossRefGoogle ScholarPubMed
Smith, R. D. (2004), ‘The reliability of willingness to pay for changes in health status’, Applied Health Economics and Health Policy, 3(1): 3538.CrossRefGoogle ScholarPubMed
Smith, R. D. (2005), ‘Sensitivity to scale in contingent valuation: the importance of the budget constraint’, Journal of Health Economics, 24: 515529.CrossRefGoogle ScholarPubMed
Smith, R. D. (2006), ‘Its not just what you do, its the way that you do it: the effect of different payment card formats and survey administration on willingness to pay for health gain’, Health Economics, 15: 281293.CrossRefGoogle ScholarPubMed
Smith, R. D.Richardson, J. (2005), ‘Can we estimate the “social” value of a QALY? Four core issues to resolve’, Health Policy, 74: 7784.CrossRefGoogle ScholarPubMed
Smith, R. D. (2007), ‘Use, option and externality values: are contingent valuation studies in health care mis-specified?’, Health Economics, 16: 861869.CrossRefGoogle ScholarPubMed
Smith, R. D. (2007a), ‘The relationship between reliability and size of willingness to pay values: a qualitative insight’, Health Economics, 16: 211216.CrossRefGoogle ScholarPubMed
Smith, R. D. (2007b), ‘The role of “reference goods” in contingent valuation: should we help respondents to “construct” their willingness to pay?’, Health Economics, 16: 13191332.CrossRefGoogle ScholarPubMed
Smith, R. D. (2008), ‘Contingent valuation in health care: does it matter how the “good” is described?’, Health Economics, 17: 607617.CrossRefGoogle ScholarPubMed
Van Houtven, G., Powers, J., Jessup, A.Yang, J.-C. (2006), ‘Valuing avoided morbidity using meta-regression analysis: what can health status measures and QALYs tell us about WTP?’, Health Economics, 15: 775795.CrossRefGoogle ScholarPubMed
Whynes, D. K., Frew, E. J.Wolstenholme, J. L. (2003), ‘A comparison of two methods for eliciting contingent valuations of colorectal cancer screening’, Journal of Health Economics, 22: 555574.CrossRefGoogle ScholarPubMed
Whynes, D. K., Frew, E. J.Wolstenholme, J. L. (2004), ‘Comparing willingness-to-pay: bidding game format vs. open-ended and payment scale formats’, Health Policy, 68: 289298.Google Scholar
Whynes, D., Frew, E., Philips, Z., Covey, J.Smith, R. D. (2007), ‘The “prominence effect” on contingent valuation’, Journal of Economic Psychology, 28: 462476.CrossRefGoogle Scholar
Yeung, R. Y. T.Smith, R. D. (2006), ‘Can we use contingent valuation to assess the private demand for childhood immunization in developing countries? A systematic review of the literature’, Applied Health Economics and Health Policy, 4: 165173.CrossRefGoogle Scholar
Yeung, R. Y. T., Smith, R. D.McGhee, S. M. (2003), ‘Willingness to pay and size of health benefit: an integrated model to test for “sensitivity to scale” ’, Health Economics, 12(9): 791796.CrossRefGoogle ScholarPubMed
Yeung, R. Y. T., Smith, R. D., Ho, L. M., Johnston, J.Leung, G. (2006), ‘Empirical implications of response acquiescence in discrete-choice contingent valuation’, Health Economics, 15: 10771089.CrossRefGoogle ScholarPubMed