Theory versus practice: a review of 'willingness-to-pay' in health and health care

Health Econ. 2001 Jan;10(1):39-52. doi: 10.1002/1099-1050(200101)10:1<39::aid-hec563>;2-e.


This paper is based upon an extensive review of 71 willingness-to-pay (WTP) surveys of health and health care published in English during the period 1985--1998. The aim of the paper is to outline the arguments advanced for the superiority of WTP over quality-adjusted-life-years (QALYs) as a measure of benefit of health care programmes, and to review how empirical WTP studies adhere to their implications. An important argument is that WTP enables a more comprehensive valuation of benefits than QALYs. Our main focus is therefore to provide a careful review of the scenario descriptions used in the surveys, according to which types of benefits are being valued, and how comprehensively the descriptions are presented. Furthermore, the 'cost-benefit argument', that WTP can assist in improving social efficiency, is discussed before we inquire into the extent to which the studies actually compare WTP with social costs.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attitude to Health*
  • Cost-Benefit Analysis
  • Data Collection / methods*
  • Financing, Personal*
  • Health Services Research / methods*
  • Humans
  • Quality-Adjusted Life Years