Subjective valuation of Iranian women for screening for gene-related diseases: a case of breast cancer.

BACKGROUND: About 5-10% of breast cancer cases are attributed to a gene mutation. To perform preventive interventions for women with a gene mutation, genetic screening BRCA tests have recently been implemented in Iran. The present study aimed to determine Iranian women's subjective valuation for screening BRCA tests for early detection of breast cancer to help policymakers to make decisions about genetic screening tests for breast cancer and to know the applicants. METHODS: An online survey was completed by women older than 30 years old in Tehran, the capital of Iran in 2021. A hypothetical scenario about genetic screening tests for breast cancer was defined. The subjective valuation for the tests was assessed by a willingness to pay (WTP) using the contingent valuation method (CVM) by payment card. Demographics, history of breast cancers, knowledge, and physiological variables were considered as independent variables, and a logistic regression model assessed the relationship between WTP and the variables. RESULTS: 660 women were included. 88% of participants intended to participate in BRCA genetic screening for breast cancer if it were free. The mean WTP for the tests was about $ 20. Based on the logistic regression, income, family history of breast or ovarian cancer, and positive attitude were associated with WTP. CONCLUSIONS: Iranian women were willing to intend for genetic screening BRCA tests and pay for them as well. The result of the present study is of great importance for policy makers when it comes to funding and determining co-payments for BRCA genetic screening tests. To achieve a high participation rate of women in breast cancer screening plans, a positive attitude should be promoted as a psychological factor. Educational and informative programs can help.

The benefits and costs of U.S. employer COVID-19 vaccine mandates.

In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and contractors and for some healthcare and private sector workers. These mandates have been challenged in court; some have been halted or delayed. However, their costs and benefits have not been rigorously appraised. This study helps fill that gap. We estimate the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, we find that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. The associated net benefits depend on the subsequent evolution of the pandemic-information unavailable ex ante to analysts or policymakers. In scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, the estimated net benefits are potentially large. They reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic. However, we do not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.

Preference of consumers for higher-grade energy-saving appliances in hierarchical Chinese cities.

Promotion of energy-saving household appliances (ESHAs) potentially contributes to optimizing both the total quantity and efficiency of household energy consumption. Differences in urban consumers' preference for higher-grade ESHAs as well as its influencing factors in cities with hierarchical socioeconomic levels remain elusive. Targeting 55 Chinese cities pertaining to three levels of socioeconomic development, we distribute questionnaires designed to cover both demographic and consciousness factors. By combining Contingent Valuation Method and multiple linear regression, the extra willingness to pay (WTP) for Grade-1/2 appliances compared with Grade-3 appliances is measured, and the influence factors on the WTP as well as consumers with highest WTP are identified. The extra WTP for Grade-1 appliances in First-, Second- and Third-level cities is 44.1%, 42.3% and 32.7%, respectively. The influences of age, household income, having children or not and monthly electricity bill parallel the socioeconomic level, while gender and schooling affect differently across socioeconomic levels. Consumers in less developed cities focus more on their affordability for the ESHAs, and in more developed cities have better environmental consciousness. Subsidies for consumers, such as those having master degree or above in First-level and Second-level cities, and having children in Third-level cities will increase their WTP. The findings provide insights for policy interventions aimed at boosting the purchase behavior for ESHAs according to local conditions for control of both household energy consumption and carbon emissions.

Willingness to pay for HPV vaccine among female health care workers in a Chinese nationwide survey.

BACKGROUND: Payment methods for human papillomavirus (HPV) vaccine could substantially influence vaccination behavior. In China, HPV vaccination uptake remains currently low. This study aims to determine willingness to pay (WTP) for HPV vaccines among Chinese female health care workers under different payment scenarios. METHODS: This is a nationwide online survey recruiting female health care workers aged 18-45 years from 31 provinces throughout China. We collected the respondents' vaccination status of HPV vaccines and their sociodemographics. Two WTPs were defined and estimated in the study. A general WTP for HPV vaccination was determined using the contingent valuation method with double dichotomous choice bidding. A WTP out-of-pocket was estimated for each HPV vaccine under two scenarios, including partial coverage by governmental subsidy or partial incorporation in basic medical insurance. Accordingly, a multivariable linear regression model was employed to determine the association between sociodemographis and general WTP. Then the maximum WTP out-of-pocket was compared among the respondents' attitude shift towards HPV vaccination, payment scenarios, and levels of vaccine attributes, using non-parametric Kruskal-Wallis test. RESULTS: A total of 15,969 respondents were included in the study. The median general WTP was 2000 CNY (interquartile range, 1000-3200 CNY), positively associated with younger age, unmarried status, higher monthly income, fewer children, more positive vaccination behavior, working in tertiary hospital, higher local GDP and HDI (each P < 0.05). Moreover, the median WTP out-of-pocket was 1250 CNY (540-2000 CNY). It was significantly higher for vaccines partly covered by governmental subsidy (median, 1250 CNY; interquartile range, 560-2000 CNY), imported vaccines (1260 CNY; 630-1960 CNY), and 9-valent vaccines (1400 CNY; 750-2240 CNY) (each P < 0.001). Additionally, majority of respondents did not change their attitude towards HPV vaccination between two payment scenarios; those remaining with more expensive HPV vaccines (51.1%) had higher WTP out-of-pocket (1400 CNY; 560-2250 CNY) than those with cheaper vaccines (39.0%) (1120 CNY; 490-1960 CNY) (P < 0.001). CONCLUSION: Chinese female health care workers have high WTP for HPV vaccines. A direct public funding for HPV vaccination is more preferable. Our findings may facilitate the adjustment of HPV vaccination strategy and payment mechanism in China.

Sample restrictions and the elicitation of a constant willingness to pay per quality adjusted life year.

It is well established that the underlying theoretical assumptions needed to obtain a constant proportional trade-off between a quality adjusted life year (QALY) and willingness to pay (WTP) are restrictive and often empirically violated. In this paper, we set out to investigate whether the proportionality conditions (in terms of scope insensitivity and severity independence) can be satisfied when data is restricted to include only respondents who pass certain consistency criteria. We hypothesize that the more we restrict the data, the better the compliance with the requirement of constant proportional trade-off between WTP and QALY. We revisit the Danish data from the European Value of a QALY survey eliciting individual WTP for a QALY (WTP-Q). Using a "chained approach" respondents were first asked to value a specified health state using the standard gamble (SG) or the time-trade-off (TTO) approach and subsequently asked their WTP for QALY gains of 0.05 and 0.1 (tailored according to the respondent's SG/TTO valuation). Analyzing the impact of the different exclusion criteria on the two proportionality conditions, we find strong evidence against a constant WTP-Q. Restricting our data to include only respondents who pass the most stringent consistency criteria does not impact on the performance of the proportionality conditions for WTP-Q.

Meta-analysis of consumers' willingness to pay for sustainable food products.

There is a continuous increase in the number of studies dealing with consumers' willingness to pay (WTP) price premiums for sustainable food products. This research focused on a broad area of sustainable food products, including different sustainable attributes using a meta-analysis of 80 worldwide studies. The publication bias was verified using the funnel plot and Egger's test. In addition, the subgroup analysis and meta-regression were applied to classify the source of heterogeneity. The results suggest that the overall WTP premium for sustainability (in percentage terms) is 29.5% on average. Furthermore, gender, region, sustainable attributes and food categories influence the average WTP estimates and their heterogeneity. Results also indicate that the WTP estimate conducted by hypothetical approach (choice experiment and contingent valuation method) is higher than non-hypothetical one due to hypothetical bias. In addition, the WTP estimate from the CVM is higher than that from the CE. Additionally, the WTP value of organic attribute is higher than the other sustainable attributes. The subgroup analysis indicates that the fruit &vegetable category has the highest WTP estimate while the seafood receives the lowest one. Results also highlight that Asian WTP estimates, in percentage terms, are higher than those obtained in North America and similar to those from Europe. In addition, positive WTP estimates are shown independent of the food categories, region or methods, denoting the presence of great market potential for sustainable products worldwide. The findings of this research can be used as a guide by food producers, marketers and policymakers when making decisions related to the sustainability of food products.

Is there any demand for improved cooking stoves? Evidence from Bangladesh.

Despite the multifarious benefits of improved cooking stoves (ICSs) over traditional biomass stoves, the ICSs adoption rate in rural Bangladesh remains nominal. This paper provides evidence that there is a growing demand for this environmentally friendly and less-hazardous stove. Using a discrete choice experiment (DCE) technique, we surveyed 259 sample households in the south-western region of Bangladesh. The results from the mixed logit model suggest that households are willing to pay (WTP) about $7 on average for a 'realistic' (i.e., one unit or 25 %) reduction in fuel consumption and smoke emission. Moreover, we found that a one-unit (33 %) reduction of cooking time and maintenance frequency increases households' WTP by about $3 and $5 respectively. Finally, this study underscores that extensive promotion, lower installation costs and higher social awareness about health risks and environmental degradation are likely to promote ICSs adoption.

The role of production process and information on quality expectations and perceptions of sparkling wines.

BACKGROUND: This study, by combining sensory and experimental economics techniques, aims to analyse to what extent the production process, and the information about it, may affect consumer preferences. Sparkling wines produced by Champenoise and Charmat methods were the object of the study. A quantitative descriptive sensory analysis with a trained panel and non-hypothetical auctions combined with hedonic ratings involving young wine consumers (N = 100), under different information scenarios (Blind, Info and Info Taste), were performed. RESULTS: The findings show that the production process impacts both the sensory profile of sparkling wines and consumer expectations. In particular, the hedonic ratings revealed that when tasting the products, both with no information on the production process (Blind) and with such information (Info Taste), the consumers preferred the Charmat wines. On the contrary, when detailed information on the production methods was given without tasting (Info), consumers liked the two Champenoise wines more. CONCLUSION: It can be concluded that sensory and non-sensory attributes of sparkling wines affect consumers' preferences. Specifically, the study suggests that production process information strongly impacts liking expectations, while not affecting informed liking. © 2018 Society of Chemical Industry.

The acceptance and willingness to pay (WTP) for hypothetical dengue vaccine in Penang, Malaysia: a contingent valuation study.

BACKGROUND: Malaysia has been experiencing an escalation in dengue cases since the past 5 years. As the dengue vaccine pipeline continues to develop steadily with strong public interests, this study had been sought to elicit the acceptance and the willingness to pay (WTP) for hypothetical dengue vaccine in Malaysia. METHODS: This study adopted the cross-sectional, contingent valuation study that involved 400 respondents in Penang, Malaysia. The double-bounded dichotomous choice via bidding game approach was employed to elicit the WTP value for two hypothetical 3-doses dengue vaccines (Vaccines A and B with 5- and 10-years' protection, respectively against dengue). A univariate logistic regression model was employed to assess the key determinants of vaccine acceptance, while the mean WTP value and its associated factors were measured by using the parametric two-part model (TPM). RESULTS: Dengue vaccine appeared to be highly acceptable (88.4%) among the population in Penang, Malaysia. Respondents who were of Chinese ethnicity (OR 0.36, p = 0.017), with higher dengue knowledge score (OR 1.43, p = 0.016), and higher vaccination attitude score (OR 1.91, p < 0.001) were more likely to accept the vaccine. The first step logit estimation from TPM displayed that pensioners (OR 2.37, p = 0.036), respondents who were self-employed or working in the private sector (OR 1.21, p = 0.002), respondents with higher education level (OR 2.09-3.29, p < 0.05), and those who accepted the vaccine (OR 3.23, p = 0.001) were more likely to pay for the vaccine. The adjusted mean WTP value for the vaccine was MYR39.21 (USD9.45) per dose. Next, the second-stage regression from TPM revealed the key factors that significantly affected the WTP value, which were composed of age, gender, occupation, household income, dengue prevention practice, and protection duration of the vaccine. The pensioners and those with better dengue prevention practice were willing to pay more for the vaccines. Additionally, all the respondents elicited a higher WTP amount toward the vaccine with longer protection duration (Vaccine B). CONCLUSION: Strong acceptance toward dengue vaccine reflects the high value of the vaccine in Malaysia. The WTP estimates offer quantification of the private benefit in reducing occurrences of the disease. Besides, the people's preferences-based WTP value for the vaccine tends to complement scientific decision-making and prioritization in the management of dengue in the country.

Determination of Cost-Effectiveness Threshold for Health Care Interventions in Malaysia.

BACKGROUND: One major challenge in prioritizing health care using cost-effectiveness (CE) information is when alternatives are more expensive but more effective than existing technology. In such a situation, an external criterion in the form of a CE threshold that reflects the willingness to pay (WTP) per quality-adjusted life-year is necessary. OBJECTIVES: To determine a CE threshold for health care interventions in Malaysia. METHODS: A cross-sectional, contingent valuation study was conducted using a stratified multistage cluster random sampling technique in four states in Malaysia. One thousand thirteen respondents were interviewed in person for their socioeconomic background, quality of life, and WTP for a hypothetical scenario. RESULTS: The CE thresholds established using the nonparametric Turnbull method ranged from MYR12,810 to MYR22,840 (~US $4,000-US $7,000), whereas those estimated with the parametric interval regression model were between MYR19,929 and MYR28,470 (~US $6,200-US $8,900). Key factors that affected the CE thresholds were education level, estimated monthly household income, and the description of health state scenarios. CONCLUSIONS: These findings suggest that there is no single WTP value for a quality-adjusted life-year. The CE threshold estimated for Malaysia was found to be lower than the threshold value recommended by the World Health Organization.

Japanese consumers' valuation of domestic beef after the Fukushima Daiichi Nuclear Power Plant accident.

After the radioactive contamination of agricultural and livestock products caused by the Fukushima Daiichi Nuclear Power Plant accident of March 11, 2011, consumer aversion against purchasing food products from the affected areas has become a major social problem in Japan. We examine how test results for radioactive materials in beef affect consumer valuation of beef produced in no-risk and affected areas using a choice experiment survey of consumers in the Tokyo metropolitan area (N = 392). Respondents were divided into two groups: one faced choice experiment tasks under the current test condition (the test status was only "under the limit"), and the other faced choice experiment tasks under the tightened test condition (with three levels: "below the limit," "below one-tenth of the limit," and "undetected"). We found that consumer valuation of "below the limit" beef in the affected area did not differ from that of "below one-tenth of the limit" beef in the affected area. Introducing the tightened status improved consumer valuations of all types of beef in the no-risk area regardless of the test status. However, consumer valuation of "undetected" beef in the affected area was lower than that in the no-risk area. The same measures need to be implemented with great care in both no-risk and affected areas. Otherwise, the effects of measures taken in the affected areas may be diluted.

Automatic price appraisals: why they matter and how to measure them.

Accurately estimating consumers' willingness-to-pay (WTP) is crucial to product design, pricing decisions, and the design of competitive marketing strategies. However, traditional self-report measures of WTP are susceptible to many reporting biases, including tactical responding or an inability to make accurate estimates. Importantly, appraisals also occur automatically (i.e., in the absence of substantial time, intention, awareness, and/or substantial cognitive resources) and implicit measures used to capture automatic appraisals are less susceptible to the sort of reporting biases that self-report measures can be affected by. However, the only existing implicit measure for assessing automatic price appraisals (the Task Rule Congruency paradigm, 'TRC') is impractical because of the large number of trials and time it requires. Accordingly, here we introduce the Implicit Attribute Classification Task (IMPACT), test its effectiveness for the measurement of automatic price appraisals (Study 1), and directly compare its effectiveness and utility with that of the TRC (Study 2). We find that the IMPACT is an efficient measure of automatic price appraisals, that it produces considerably larger effects compared to the TRC, and that it does so while substantially shortening the procedure. We also discuss how the IMPACT scores can be used to derive an implicit measure of willingness to pay. Our findings make a substantial contribution to both research and practice by providing an effective tool that facilitates, for the first time, an efficient exploration of implicit WTP.

Willingness to pay for an mRNA-based anti-cancer treatment: results from a contingent valuation study in Israel.

BACKGROUND: mRNA technology is currently being investigated for a range of oncology indications. We assessed the willingness to pay (WTP) of the general population in Israel for a hypothetical novel mRNA-based treatment for oncology indications. METHODS: We used a contingent valuation methodology to elicit WTP using a web-based questionnaire. A sample of adult participants were presented with a hypothetical scenario in which an mRNA-based intervention increased the likelihood of a cure for various cancer types from 20% to 40% (half of the sample), or 60% (the other half of the sample). RESULTS: 531 respondents completed the questionnaire. The mean, median and mode WTP for the proposed hypothetical treatment in both scenarios were ILS65,000 (± ILS114,000), ILS20,000 and ILS50,000, respectively (1USD = 3.4ILS). The WTP was skewed towards zero, and 9.6% of the respondents were not willing to pay any amount. WTP higher amounts was significantly associated with higher income (p < 0.01), self-reported good health (p < 0.05), supplementary health insurance (p < 0.05), Jews compared to other populations (p < 0.01), interest in technology (p < 0.001) and a tendency to adopt medical innovations (p < 0.001). No statistical difference between the 40% vs. the 60% potential cure scenarios was found. Logistic and OLS regressions indicated that age, religion, income, and interest in adopting medical innovations were the best predictors of respondents' WTP. CONCLUSION: Despite the scientific breakthroughs in oncology treatment over the last few decades, many types of cancer are still incurable. Given the expected development of innovative mRNA-based treatments for cancer, these results should inform policymakers, the pharmaceutical industry and other stakeholders on the future coverage and reimbursement of these technologies incorporating patients' and societal views. To date, WTP considerations have not been given much weight in prioritization of drug reimbursement processes, neither in Israel nor in other countries. As a pioneer in adoption of the mRNA technology, Israel can also lead the incorporation of WTP considerations in this field.

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.

Consumer Preference and Willingness to Pay for Rice Attributes in China: Results of a Choice Experiment.

Understanding urban consumers' preferences for rice attributes is crucial for rice breeders, producers, and retailers to meet diverse and evolving market demands. Based on the sample data of 629 rice consumers in Shanghai, China, obtained through the choice experiment (CE) approach, this study uses the mixed logit (ML) model to analyze consumers' preferences and willingness to pay (WTP) for food safety labels, brands, nutritional quality, and taste quality. Furthermore, the latent class (LC) model examines the heterogeneity in consumer group preferences. The research findings highlight that consumers prioritize taste quality as the most crucial attribute, followed by nutritional quality, food safety labels, and brand attributes. The premium rates for superior taste quality, organic certification labels, and green certification labels exceeded 100%. Interestingly, while combining organic certification with well-known international or domestic brands does not uniformly boost consumer preferences, incorporating green certification alongside well-known international or domestic brands significantly elevates those preference levels. Factors such as the external environment, consumption habits, and personal characteristics significantly influence individuals' preferences for rice attributes. Based on these insights, the study puts forth policy recommendations for rice breeders, producers, and retailers.

Consumers' Willingness to Pay for Pharmacist Counselling Services and the Factors Affecting It in Community Pharmacies.

Background: Community pharmacists play an important role in improving outcome by providing advice and counselling services to patients. Objectives: The aim of this study was to measure the willingness to pay (WTP) for pharmacist counselling services in community pharmacies and identify determinant factors on consumers' WTP. Methods: A self-administered questionnaire-based survey was conducted in community pharmacies in Tehran (capital of Iran) from January 1, 2020 to February 20, 2021. Contingent valuation method was applied to evaluate respondents' maximum WTP using three hypothetical scenarios illustrating different levels of counselling services. Logistic regression was used to analyze the association between different variables and WTP for pharmacy services. Results: Total number of participants who completed the questionnaire were 332 and 60% of the participants were male. In the first scenario 70.2% of participants were willing to pay for oral counselling pharmacy services. In the second and third scenario, percentage of people willing to pay increased to 79.5%. and 86.1%, respectively. In the first scenario, monthly income (OR = 0.041, P value = 0.04), the duration of underlying illness (OR = 0.04, P value = 0.04) and the using internet (OR = 2.59, P value = 2.59) had a statistically significant relationship with willingness to pay. In the third scenario, the willingness to pay increased as the age decreased. The possibility of using the internet (OR = 3.32, P value = 0.00) and the need for a community pharmacist (OR = 2.19, P value = 0.03) increased the chance of willingness to pay. Conclusions: More consumers are willing to pay for more pharmacist counselling services. Therefore, improving the quality of counselling services could have positive economic effects on community pharmacies.

Assessing Italian household preferences for waste sorting systems: The role of environmental awareness, socioeconomic characteristics, and local contexts.

Efficient Waste Management Systems (WMS) depend on citizens' willingness to sort waste and to cooperate for its improved provision. Thus, it is essential to understand what attributes individuals value the most and what drives WMS preference heterogeneity. In this paper, we investigate how individuals evaluate WMS attributes (e.g., the number of waste sorting categories, the introduction of textile sorting, and the frequency of collection per week) and how the local contexts, socioeconomics, and environmental values shape their preferences. For this purpose, we conducted a discrete choice experiment on a sample representative of the Italian population interviewed through an online panel survey. We collected information on individual's preferences for WMS attributes, environmental awareness, and socioeconomic characteristics. We analyzed the data using hybrid mixed choice models, which allowed us to integrate environmental awareness values into willingness to pay estimations. We found that individuals are willing to pay for waste sorting, even if this implies more effort on their part and increased storage space. In addition, we found that the extent to which individuals support WMS improvements strongly depends on their environmental values, experiences (which are shaped by their local context), and socioeconomic factors. Our results suggest that to increase recycling rates and citizen satisfaction, there is a need for context-specific WMS designs that acknowledge the observed heterogeneity of preferences.

Does in vitro fertilization (IVF) treatment provide good value for money? A cost-benefit analysis.

Background: Using traditional health technology assessment (HTA) outcome metrics, such as quality-adjusted life-years, to assess fertility treatments raises considerable methodological challenges because the objective of fertility treatments is to create new life rather than extend, save, or improve health-related quality of life. Objective: The aim of this study was to develop a novel cost-benefit framework to assess value for money of publicly funded IVF treatment; to determine the number of cost-beneficial treatment cycles for women of different ages; and to perform an incremental cost-benefit analysis from a taxpayer perspective. Methods: We developed a Markov model to determine the net monetary benefit (NMB) of IVF treatment by female age and number of cycles performed. IVF treatment outcomes were monetized using taxpayers' willingness-to-pay values derived from a discrete choice experiment (DCE). Using the current funding environment as the comparator, we performed an incremental analysis of only funding cost-beneficial cycles. Similar outputs to cost-effectiveness analyses were generated, including net-benefit acceptability curves and cost-benefit planes. We created an interactive online app to provide a detailed and transparent presentation of the results. Results: The results suggest that at least five publicly funded IVF cycles are cost-beneficial in women aged <42 years. Cost-benefit planes suggest a strong taxpayer preference for restricting funding to cost-beneficial cycles over current funding arrangements in Australia from an economic perspective. Conclusions: The provision of fertility treatment is valued highly by taxpayers. This novel cost-benefit method overcomes several challenges of conventional cost-effectiveness methods and provides an exemplar for incorporating DCE results into HTA. The results offer new evidence to inform discussions about treatment funding arrangements.

Willingness to pay for hepatitis B virus vaccine and associated factors among households in Bahir Dar City, northwest Ethiopia: using contingent valuation method.

Background: The prevention of disease burden and death through vaccination is one of the most cost-effective methods. Even though the Hepatitis B Virus (HBV) has significant public health problems in Ethiopia, there is no compulsory HBV vaccination program for adults and the vaccine's market value was not yet estimated in the Ethiopia context. Therefore, this study aimed to assess the willingness to pay (WTP) for the HBV vaccine and its associated factors among households in Bahir Dar City, northwest Ethiopia. Methods: A cross-sectional study was conducted among 620 households from March 1 to 30, 2020. A systematic random sampling technique was employed to select the required number of households. An interviewer-administered questionnaire was used to collect the necessary information. The contingent valuation method was conducted to measure WTP for the HBV vaccine. A Tobit regression model was employed to investigate significantly associated factors, and variables with a p-value of <0.05 were considered statistically significant. Results: In this study, 62.17% of households were willing to pay for the HBV vaccine with an average cost of ETB174.24 (US$5.25). Male household heads (P = 0.014), favorable attitude (P = 0.017), and good knowledge (P < 0.001) toward the vaccine were positively associated with WTP, whereas age (P < 0.001), single marital status (P = 0.012) and divorced/widowed (P = 0.018) marital status were negatively associated with WTP. Conclusions: Overall, most households were willing to pay for the HBV vaccine with an average demand of ETB174.24 (US$5.25). Therefore, a national-level HBV vaccine strategy should be designed considering the households' willingness to pay. In addition, working on attitudes and knowledge toward the vaccine could potentially increase the household's willingness to pay for the HBV vaccine.

Interrogating COVID-19 vaccine intent in the Philippines with a nationwide open-access online survey.

To mitigate the unprecedented health, social, and economic damage of COVID-19, the Philippines is undertaking a nationwide vaccination program to mitigate the effects of the global pandemic. In this study, we interrogated COVID-19 vaccine intent in the country by deploying a nationwide open-access online survey, two months before the rollout of the national vaccination program. The Health Belief Model (HBM) posits that people are likely to adopt disease prevention behaviors and to accept medical interventions like vaccines if there is sufficient motivation and cues to action. A majority of our 7,193 respondents (62.5%) indicated that they were willing to be vaccinated against COVID-19. Moreover, multivariable analysis revealed that HBM constructs were associated with vaccination intention in the Philippines. Perceptions of high susceptibility, high severity, and significant benefits were all good predictors for vaccination intent. We also found that external cues to action were important. Large majorities of our respondents would only receive the COVID-19 vaccines after many others had received it (72.8%) or after politicians had received it (68.2%). Finally, our study revealed that most (21%) were willing to pay an amount of PHP 1,000 (USD20) for the COVID-19 vaccines with an average willing-to-pay amount of PHP1,892 (USD38).