Economic valuation of a mesocarnivore's impact management

Red foxes (Vulpes vulpes) have interacted with humans during their common history. We used a contingent valuation method to assess the economic value of the management of this mesocarnivore's negative impacts. We carried out face-to-face interviews with 746 Greek residents, using a multiple-bounded discrete choice approach to estimate willingness to pay (WTP) for red fox management under three impact situations: attack domestic animals, reduce game, carry disease. About 51.9%, 33.0%, and 81.1% of the respondents stated a mean WTP of €34.1, €44.9, and €72.1 for each situation, respectively. The total annual amounts of €18.7 million, €15.7 million, and €61.7 million could be collected from the target population for red fox management when they attack domestic animals, reduce game, and carry disease, respectively. Attitudes and likeability toward foxes were negatively associated while knowledge about foxes and fear of them were positively associated with WTP. The younger, richer, less educated, rural, farmers, hunters, and pet owners were generally more willing to pay for red fox management across situations. Females were more willing to pay for managing predation on domestic animals, while males were more willing to pay for managing predation on game. Our findings showed that the Greek residents highly value the management of red foxes in all impact situations and would be valuable for further advising the management process.

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.

How do American and British Nonsmokers Value Secondhand Smoke Health Risks?

Despite concerted efforts to enforce smoke-free laws in various countries, nonsmokers, particularly women and children, continue to be exposed to daily secondhand smoke (SHS), resulting in significant health risks. While existing studies have assessed the health effects of numerous diseases, the quantification of SHS spillovers remains understudied. This research employs choice experiments and contingent valuation techniques to rigorously quantify the attributes of SHS health risks, with a specific emphasis on facilitating cross-country comparisons. Our investigation reveals that nonsmoking individuals in the United Kingdom exhibit an attitude of indifference towards a proposed policy offering increased disposable income as compensation for SHS exposure. Conversely, nonsmoking Americans express a contrary perspective. Furthermore, our study demonstrates that nonsmoking Americans attribute a higher value to SHS health risks compared to their British counterparts. Consequently, this research uncovers a hitherto unexplored dimension of health risk-related behaviors. These findings hold the potential to significantly contribute to the development of future smoke-free policies, offering valuable insights that can inform policy decisions and address the persistent challenges associated with SHS exposure, particularly among vulnerable populations.

Willingness to pay for cancer prevention versus treatment in China: implications for cost-effectiveness threshold

BACKGROUND

Empirical support for the appropriate cost-effectiveness threshold (CET) in China remains sparse.

OBJECTIVE

This study aimed to estimate the willingness to pay (WTP) for cancer prevention and treatment from the perspective of healthcare policy-makers (i.e. supply side) and to investigate whether there is a difference between the estimated WTP in two scenarios.

METHODS

We conducted a web-based survey from May to July 2022 among experts who offering consultation to the government. We surveyed 79 experts from a national think-tank (84.81% response rate) using contingent valuation method, a method for estimating the monetary value that individuals place on a non-market service.

RESULTS

The mean WTP for two scenarios were estimated at 1.29 times of per capita Gross Domestic Product (GDP) of China and 1.90 times of per capita GDP, respectively. There was a difference between the WTP in the two scenarios and the WTP for treatment was significantly higher than prevention.

CONCLUSION

The findings suggest that though there is a smaller gap between the two scenarios in China as compared to other countries, the WTP may vary under different scenarios. So there's a need to further refine the development of CET by adding parameters like prevention instead of defining one universal threshold.

Factor associated with willingness to pay for prevention of cancer: a study of prostate cancer screening

INTRODUCTION

This study investigates Iranian men's willingness to pay (WTP) for prostate cancer (PCa) screening and influencing factor, along with the impact of information.

METHOD

We assessed preferences for prostate cancer screening in 771 Iranian men aged 40 and above using an internet-based questionnaire survey. Participants received basic and complementary information, and their willingness to pay was determined through a payment card approach. A Wilcoxon test assessed the impact of information. We also analyzed prostate cancer screening demand and employed Heckman's two-step model to evaluate factors influencing the willingness to pay. Additionally, reasons for unwillingness to pay were explored.

RESULTS

Willingness to pay significantly decreased with complementary information relative to basic information (16.3$ vs 17.8$). Heckman model, using WTP based on basic information shows age, education, and monthly household expenditure positively influenced the decision to pay. In contrast, health status, expectations of remaining life and prostate problems history positively affect amount of WTP for PCa screening, and insurance coverage has a negative impact on it. Majority of respondents (91%) supported PCa screening, with 82% expressing a willingness to pay. Common reasons for not paying include seeing screening as a public good (43%), financial constraints (35%), and having insurance (20%). The screening demand is price-sensitive.

CONCLUSION

The basic mindset of Iranian men exaggerates the risk of prostate cancer. Reduced willingness to pay after receiving information reassures the reliability of their financial expectation. Taking into account the factors that influence PCa screening is essential for accurate planning and the successful implementation of this program.

Assessing farmer willingness to participate in a subsidized veterinary herd health management program

Zoonoses, such as COVID-19, can cause pandemics with many fatalities. Therefore, livestock keepers should attach great importance to livestock disease control. Veterinarians can support farmers in this task through a structured veterinary herd health management (VHHM) program. The dissemination of these programs remained low, and Swiss policy makers planned to launch a subsidy program for VHHM. To inform policy making ex-ante, a survey of 1600 Swiss dairy farmers was conducted to determine whether they are willing to participate and how much they are willing to pay. Contingent evaluation with a discrete choice format elicited willingness to pay (WTP). As a rather high share of farmers who would not participate was expected, a spike model was applied with a single-bounded discrete choice (SBDC) model. Only 47% of the farmers had a positive WTP. Mean WTP in the SBDC was CHF 10.47 per cow and year and in the spike model CHF 57.96. Participation would increase with higher subsidy levels. If the government pays 20% of the costs and farmers pay CHF 96 per cow per year, 23.6% of farms would participate. If the subsidy increases to 80% (CHF 24 for farmers), 40.4% would participate. A logistic regression indicates younger and older farmers, those with lower veterinary costs, and those who consider VHHM relevant only for farms with problems are less likely to participate.

Farm impacts of the 2019 Missouri River floods and economic valuation of flood risk reduction

The 2019 Missouri River flood caused billions of dollars in damage to businesses, homes, and public infrastructure. Yet little is known about the farm-level effects of this event and farmers' perceptions of its causes. This study reports on the operational and financial setbacks farmers sustained because of the 2019 floods, as well as on their beliefs on the causes of these floods. It further explores farmers' willingness to pay (WTP) to avoid flood risks and the factors that condition it. The empirical application focuses on a sample of approximately 700 Missouri farmers operating near the Missouri River. Results show that yield loss, loss of growing crops, and inability to plant crops were the three most important consequences of flooding. Nearly 40% of the flood-affected farmers reported financial losses of $100,000 or more. Most respondents identified government decision makers as the cause of the 2019 floods, and many believe that government should prioritize flood control over other benefits (recreation and fish and wildlife habitat) the Missouri River system provides. The WTP results show that less than half of the surveyed farmers were willing to pay to avoid flood risks, with an average WTP estimated at $3 per $10,000 value of agricultural land. Subjective but not objective risk exposure influences WTP for flood risk reduction. Other important determinants of WTP are risk aversion, disutility from flood risks, and respondents' age, income, and education. Directions for policy to improve flood risk management in the Missouri River Basin are discussed.

Estimating the monetary value of a Quality-Adjusted Life-Year in Quebec

BACKGROUND

The value of a Quality-Adjusted Life-Year (QALY) is of great importance for the healthcare system. It helps when it comes to defining a cost-effectiveness threshold for the evaluation of health technologies. No willingness-to-pay value for a QALY exists in the province of Quebec, Canada.

OBJECTIVES

In this paper, we empirically investigated the monetary value of a QALY for the population of Quebec.

METHODS

Based on the Short-Form 6-Dimension version 2 (SF-6Dv2), we conducted an online survey with a representative adult sample living in Quebec. We used a time trade-off (TTO) combined with contingent valuation (CV), and a discrete choice experiment (DCE) to assess both the population's willingness to pay (WTP) for one QALY and the marginal WTP for health attributes. A health utility algorithm using hybrid regression was developed to determine a preference-based value set for health states.

RESULTS

Main analysis was conducted on 993 answers for the CV and 2143 answers for the DCE. The willingness-to-pay per QALY varied from CA$ 47,048.84 (CI: 21,554.38; 72,543.30) for CV to CA$ 73,936.87 (CI: 63,105.40; 84,768.35) for DCE. Among the 6 dimensions of the SF-6Dv2, marginal WTP varied from CA$ 4499.15 (CI: 2975.06; 6023.25) for more role accomplishment in daily activities to CA$ 15,867.12 (CI: 13,825.75; 17,908.49) for less pain. Robustness check with multiple alternative samples, as well as alternative health utility algorithms, showed that the results were robust and the DCE method provided 50% larger results than the CV method, although confidence intervals overlap.

CONCLUSION

This paper provides useful information for decision-makers on the monetary value of a QALY in Quebec.

Are Citizens Ready to Make an Environmental Effort? A Study of the Social Acceptability of Biogas in France

Despite the potential benefits of anaerobic digestion in the context of climate change and the need to move towards energy transition, there is a lot of resistance to biogas projects. Using a contingent valuation method, we test the extent to which the socio-economic characteristics of populations influence the environmental effort that people are willing to make for the deployment of biogas in a French region. Our results show that young people and people familiar with the biogas process are more inclined to develop biogas. We also highlight that the educational and location aspects should not be neglected in order to increase environmental effort and promote the adoption and development of biogas.

Monetary valuation of COVID-19 informal care: caregivers' willingness to pay and willingness to accept

BACKGROUND

Informal care can reduce hospitalization frequency and time, elevate bed turnover, and increase the health systems' capacity. This type of care has shown meaningful value in managing many cases through the COVID-19 pandemic. The present study aimed to identify determinants of monetary valuation of informal care and the burden of this care on the COVID-19 patients' caregivers.

METHODS

Through a cross-sectional phone survey from June to September 2021 in Sanandaj city, the west of Iran, COVID-19 patients and their caregivers (Each Group No. 425) were separately interviewed. A simple probabilistic sampling method was applied. Two questionnaires were developed and used after validation. Monetary valuation of informal caregivers was done using Willingness to pay (WTP) and willingness to accept (WTA). Double hurdle regressions were used to determine related variables to WTP/WTA. R software was used for the data analysis.

RESULTS

The total mean (Standard Deviation) of WTP and WTA were $12.02(28.73), $10.30(15.43) USD. Most respondents put a zero value on informal care by WTA (243(57.18%) and WTP [263 (61.88%)]. Caregivers' Employment, and being spouse/child of the care recipient increased the probability of reporting a positive value for WTP (p-value < 0.0001, p-value = 0.011 respectively) and WTA (p-value = 0.004, p-value < 0.0001 respectively). An increase in the number of caring days decreased the probability of reporting positive WTA (p-value = 0.001) and increased the mean of lnWTP (p-value = 0.044). Perceived difficulty in doing indoor activities and perceived difficulty in doing outdoor activities decreased lnWTA mean (p-value = 0.002) and lnWTP mean (p-value = 0.043) respectively.

CONCLUSIONS

Increasing caregivers' self-efficacy and facilitating their involvement in the caring process could be facilitated through flexible work status, educational programs, and interventions on decreasing their burnout.

Is the intention to vaccinate enough? Systematic variation in the value of timely vaccinations and preferences for monetary vs non-monetary incentives among pregnant women in southern Tanzania

Background

Globally, approximately 19.7 million children remain under-vaccinated; many more receive delayed vaccinations. Sustained progress towards global vaccination targets requires overcoming, or compensating for, incrementally greater barriers to vaccinating hard-to-reach and hard-to-vaccinate children. We prospectively assessed pregnant women's valuations of routine childhood vaccinations and preferences for alternative incentives to inform interventions aiming to increase vaccination coverage and timeliness in southern Tanzania.

Methods

Between August and December 2017, 406 women in their last trimester of pregnancy were enrolled from health facilities and communities in the Mtwara region of Tanzania and asked contingent valuation questions about their willingness to vaccinate their child if they were (a) given an incentive, or (b) facing a cost for each vaccination. Interval censored regressions assessed correlates of women's willingness to pay (WTP) for timely vaccinations. Participants were asked to rank monetary and non-monetary incentive options for the timely vaccination of their children.

Findings

All women expected to get their children vaccinated according to the recommended schedule, even without incentives. Nearly all women (393; 96.8 %) were willing to pay for vaccinations. The average WTP was Tanzania Shilling (Tsh) 3,066 (95 % confidence interval Tsh 2,523-3,610; 1 USD ∼ Tsh 2,200) for each vaccination. Women's valuations of timely vaccinations varied significantly with vaccine-related knowledge and attitudes, economic status, and rural vs urban residence. Women tended to prefer non-monetary over monetary incentives for the timely vaccination of their children.

Interpretation

Women placed a high value on timely childhood vaccinations, suggesting that unexpected system-level barriers rather than individual-level demand factors are likely to be the primary drivers of missed vaccinations. Systematic variation in the value of vaccinations across women reflects variation in perceived benefits and opportunity costs. In this setting, nonmonetary incentives and other interventions to increase demand and compensate for system-level barriers hold significant potential for improving vaccination coverage and timeliness.

ClinicalTrialsgov Protocol

NCT03252288.

Benefit-cost analysis of becoming certified pollinator friendly

Despite significant drop in pollinator abundance, no studies exist on the benefits and costs of pollinator conservation in the public domain. An in-person survey was conducted at three large, public US universities to estimate benefits to become Bee Campus USA certified. We test whether different types of reminders on existing student sustainability fees affect Willingness to Pay. Costs of achieving this certification per university were obtained. Net Present Value demonstrates that the net benefits to each school are largely positive, except under the most restrictive assumption. Information reminders of existing fees lead to little change in support of pollinator conservation.

Incentivizing COVID-19 vaccination among racial/ethnic minority adults in the United States: $209 per dose could convince the hesitant

BACKGROUND

More than two years into the coronavirus disease (COVID-19) pandemic, it remains unclear whether financial incentives can reduce vaccine hesitancy and improve uptake among key unvaccinated populations. This study estimated the willingness of racial/ethnic minority adults in the United States to accept financial incentives for COVID-19 vaccination and the minimum amount needed to vaccinate a sufficiently high percentage of this population.

METHODS

From August through September 2021, we conducted an online survey of 367 Black/African American and Hispanic patients, age ≥ 18 years, from 8 community health centers in Rhode Island. Contingent valuation questions assessed respondents' willingness-to-accept (WTA) incentives for COVID-19 vaccination using random-starting-points and iterative incentive offers of $5 to $50 per dose. Ordered logistic regression models examined associations between respondent characteristics and WTA. Predictive probabilities were modeled using both within-survey range and out-of-survey range incentive offer amounts and compared against vaccination thresholds needed to reach herd immunity.

RESULTS

Less than 30% of unvaccinated survey respondents were WTA an incentive of $50/dose for vaccination. Models using out-of-survey incentive offer amounts greater than $50 suggested that 85% of respondents would agree $140/dose (95% CI: $43-$236) could convince other people to accept vaccination, while $209/dose (95% CI: -$91-$509) would be needed for 85% of respondents to accept vaccination themselves.

CONCLUSIONS

Findings from this analysis may inform the design of incentive schemes aiming to reduce racial/ethnic disparities in vaccine and booster uptake, which will continue to be important as new variants of SARS-CoV-2 emerge.

Preferences of cancer patients as a guide to cancer prevention: a retrospective willingness to pay study in Nepal

OBJECTIVE

In developing countries, like Nepal, with no population-based cancer registry and low level of awareness, it is difficult to communicate the significance of cancer preventative measures to the general population. Only patients, who have faced or facing the economic and mental burden of cancer, can better understand the importance of early diagnosis. This led us to study the retrospective preference of cancer patients in valuing an annual comprehensive cancer screening program in Nepal.

STUDY DESIGN

This is a primary survey-based study of 600 diagnosed cancer patients (aged 18+ years) randomly sampled from five hospitals of Nepal during December 2015-February 2016.

METHODS

Using the contingent valuation estimation methods, we modelled patients' willingness to pay (WTP) for early cancer screening through the Structural Equation Modelling framework.

RESULTS

About 59% of our sampled patients did not receive education and 65% earned below $100/month. Among other findings, we saw that the Risk of re-occurrence impacted WTP through two opposing channels. The direct effect of Risk of re-occurrence on WTP was positive (β = 0.20; p < 0.05), but higher the risk of cancer relapses, the higher was the Pessimism among patients, which indirectly impacted WTP negatively (β = -0.16; p < 0.1). In addition, we found the effect of Income on WTP to be positive (β = 0.15; p < 0.05), whereas, one belonging to the backward Dalit section of the society had lower WTP for screening.

CONCLUSION

Cancer patients value the importance of early diagnosis with multiple psychosocial factors impacting this preference. This direct account of patients could be used as evidence in policymaking.

Determinants of willingness to pay for health services: a systematic review of contingent valuation studies

INTRODUCTION

Stated preference studies are a valuable tool to elicit respondents' willingness to pay (WTP) for goods or services, especially in situations where no market valuation exists. Contingent valuation (CV) is a widely used approach among stated-preference techniques for eliciting WTP if prices do not exist or do not reflect actual costs, for example, when services are covered by insurance. This review aimed to provide an overview of relevant factors determining WTP for health services to support variable selection.

METHODS

A comprehensive systematic literature search and review of CV studies assessing determinants of WTP for health services was conducted, including 11 electronic databases. Two of the authors made independent decisions on the eligibility of studies. We extracted all determinants used and related p values for the effect sizes (e.g. reported in regression models with WTP for a health service as outcome variable). Determinants were summarised in systematic evidence tables and structured by thematic domains.

RESULTS

We identified 2082 publications, of which 202 full texts were checked for eligibility. We included 62 publications on 61 studies in the review. Across all studies, we identified 22 WTP determinants and other factors from 5 thematic domains: sociodemographic characteristics, perceived threat, perceived benefit, perceived barriers, and other information.

CONCLUSION

Our review provides evidence on 22 relevant determinants of WTP for health services, which may be used for variable selection and as guidance for planning CV surveys. Endogeneity should be carefully considered before interpreting these determinants as causal factors and potential intervention targets.

Public willingness to pay for eradicating a harmful marine organism: the case of Aurelia aurita in South Korea

Aurelia aurita (AA), a legally registered harmful marine organism in South Korea, is damaging marine human leisure activities, local residents' tourism income, fisheries, and cooling water intake at power plants. The government is therefore seeking to eradicate AA by removing AA-attached larvae (polyps). This article looks into the public willingness to pay (WTP) for the eradication, utilizing a contingent valuation. For the sake of eliciting the WTP response, the one-and-one-half-bounded (OB) model was adopted. For comparison, the single-bounded (SB) model, which uses only the response to the first question in the OB model, was also applied. A spike model with a considerable plausibility that could explicitly deal with zero WTP responses was employed. Consequently, the estimation results of the SB model were used for further policy analysis. The household average WTP was estimated as KRW 3,911 (USD 3.49) per year, securing statistical significance. The national value was KRW 80.46 billion (USD 71.71 million) per annum. This figure can be interpreted as public value of the AA eradication project and used as essential basic data to evaluate the economic feasibility of implementing the project. Some factors such as income and education level significantly positively affected the intention of paying a suggested bid.

Willingness to pay for health gains from an international integrated early warning system for infectious disease outbreaks

Recently, due to the corona virus outbreak, pandemics and their effects have been at the forefront of the research agenda. However, estimates of the perceived value of early warning systems (EWSs) for identifying, containing, and mitigating outbreaks remain scarce. This paper aims to show how potential health gains due to an international EWS might be valued. This paper reports on a study into willingness to pay (WTP) in six European countries for health gains due to an EWS. The context in which health is gained, those affected, and the reduction in risk of contracting the disease generated by the EWS are varied across seven scenarios. Using linear regression, we analyse this 'augmented' willingness to pay for a QALY (WTP-Q) for each of the scenarios, where 'augmented' refers to the possible inclusion of context specific elements of value, such as feelings of safety. An initial WTP-Q estimate for the basic scenario is €17,400. This can be interpreted as a threshold for investment per QALY into an EWS. Overall, WTP estimates move in the expected directions (e.g. higher risk reduction leads to higher WTP). However, changes in respondents' WTP for reductions in risk were not proportional to the magnitude of the change in risk reduction. This study provided estimates of the monetary value of health gains in the context of a pandemic under seven scenarios which differ in terms of outcome, risk reduction and those affected. It also highlights the importance of future research into optimal ways of eliciting thresholds for investments in public health interventions.

Citizens' preferences on green infrastructure practices and their enhancement in Portland, Oregon

Green infrastructure (GI) has been gaining increasing attention due to its efficiency in controlling and purifying urban stormwater runoff, creating environmental amenities, and biodiversity conservation. Nevertheless, the existing knowledge of people's preferences for GI is not yet sufficient for evidence-based policymaking for enhancing GI. This study analyzes citizens' perceptions of the relative importance of six GI practices and estimates their willingness to pay (WTP) to enhance them. To this end, the study applies two types of stated preference methods (best-worst scaling and contingent valuation) to citizen survey data collected in Portland, Oregon. We found that GI practices that are more likely to lead to private benefits (e.g., rain barrels, urban trees) received relatively higher ratings, whereas the ratings of practices that do not offer such benefits (e.g., bioswales, rain gardens) were relatively lower. However, the diversity of preferences was large, as the relative importance varied widely among respondents. Heterogeneous preferences were also found in terms of citizens' WTP for hypothetical GI enhancement. Our comparison of uniform and variable payment schemes revealed that variable payment outperformed uniform payment because of the significant variation in citizens' WTP. The difference was large when the annual household payment was small.

Willingness to pay to enhance pandemic preparedness in Mauritius

OBJECTIVES

The objective of this study is to assess the determinants of willingness to pay to enhance pandemic preparedness in Mauritius.

STUDY DESIGN

A contingent valuation method is used to estimate willingness to pay to pay for enhancing pandemic preparedness using a sample of working people in Mauritius.

METHODS

A two-phase decision process analysis is carried out to model the willingness to pay to enhance pandemic preparedness. The first phase is to analyse the respondents' decision of whether or not to pay for enhancing pandemic preparedness using a Probit model. The second phase is to estimate the determinants of the amount of money respondents are willing to pay using a Tobit model.

RESULTS

Income earners are willing to pay an average of Rs. 1,900 (approximately USD 50) per annum to enhance pandemic preparedness. 'Perceived Response Efficacy', 'Awareness of the Need and Responsibility for Paying', 'Subjective Obligation to Pay' and the 'Theory of Planned Behaviour' are found to affect both stages of of the decision-making process. Knowledge on COVID-19 is found to have a positive impact on the decision to pay and health responsibility attitude is found to have a negative impact on the amount people are willing to pay.

CONCLUSIONS

On average, the government can potentially expect to mobilise an additional Rs. 1,047,470,000 (USD 27,565,000) from taxpayers to spend on enhancing pandemic preparedness in Mauritius. To increase willingness to pay for enhanced pandemic preparedness, the government can focus on improving knowledge on a pandemic, perceived response efficacy and awareness on need and responsibility of paying.

The contingent equilibrium during imbalanced volcano tourism demand through fee estimation: An empirical analysis of tourism in Mount Etna

Volcanic sites can be considered strategic areas for conservation and protection policies, but such policies may involve considerable costs However, not only are volcanic sites often integral to the tourism industry and, hence, of potential significant benefit to local economies in general; entrance fee income from tourists can also contribute to management and conservation costs in particular. Nevertheless, seasonal variations in tourism demand, resulting in over-and under-tourism situations, may impact on both the level of income generated as well as on the sustainability of sites Therefore, based on a case study of Mt Etna in Italy, this study considers establishing appropriate entry fee levels for volcano areas. First, a logit model is applied to the relevant socio-demographic and site-specific variables. The entrance fees are estimated on visitors' willingness to pay and demand elasticity. Applying contingent valuation method (CVM), two groups of tourists (high and low season visitors) are identified and surveyed, with each group demonstrating different willingness to pay and elasticity levels. Rather than applying a single fee, different entrance fees for the two groups are found to generate a higher level of revenue for the park's economic equilibrium. In addition, the different entrance fees offer the potential to mitigate the peak effects of over-tourism and support demand during under-tourism, with clear sustainability consequences. The results, which confirm four hypotheses set about Mt. Etna, could facilitate decision-makers in determining a feasible balance between management costs, tourism demand characteristics and protection commitments.

Willingness-to-pay for cancer treatment and outcome: a systematic review

BACKGROUND

Understanding patient preferences in cancer management is essential for shared decision-making. Patient or societal willingness-to-pay (WTP) for desired outcomes in cancer management represents their preferences and values of these outcomes.

OBJECTIVE

The aim of this systematic review is to critically evaluate how current literature has addressed WTP in relation to cancer treatment and achievement of outcomes.

METHODS

Seven databases were searched from inception until 2 March 2021 to include studies with primary data of WTP values for cancer treatments or achievement of outcomes that were elicited using stated preference methods.

RESULTS

Fifty-four studies were included in this review. All studies were published after year 2000 and more than 90% of the studies were conducted in high-income countries. Sample size of the studies ranged from 35 to 2040, with patient being the most studied population. There was a near even distribution between studies using contingent valuation and discrete choice experiment. Based on the included studies, the highest WTP values were for a quality-adjusted life year (QALY) ($11,498-$589,822), followed by 1-year survival ($3-$198,576), quality of life (QoL) improvement ($5531-$139,499), and pain reduction ($79-$94,662). Current empirical evidence suggested that improvement in QoL and pain reduction had comparable weights to survival in cancer management.

CONCLUSION

This systematic review provides a summary on stated preference studies that elicited patient preferences via WTP and summarised their respective values. Respondents in this review had comparable WTP for 1-year survival and QoL, suggesting that improvement in QoL should be emphasised together with survival in cancer management.

The demand for a COVID-19 vaccine

Taking willingness to pay as primitive, this paper establishes an analytical framework for demand estimation, where the estimator is robust to endogeneity of price. Applying the framework, this paper then estimates demand functions for a COVID-19 vaccine and compute the consumer surplus in both China and the UAE. We find that the price elasticities of demand are mostly greater than one in both countries. An elastic demand suggests subsidy is likely to be successful in promoting vaccination. The consumer surplus is sizeable, around 58 billion US$ in China and 646 million US$ in the UAE. The figures can inform policymakers in assessing their vaccine programs.

Willingness to Pay for Gray and Green Interventions to Augment Water Supply: A Case Study in Rural Costa Rica

Many rural communities in developing countries experience severe water shortages, limiting their capacity for self-sustainability. This study used contingent valuation and choice experiment methods and in-person interviews to estimate household willingness to pay (WTP) for gray and green interventions to augment water supply in rural Costa Rica. In particular, we examined residents' preferences for well construction, as a form of gray intervention, and reforestation, as a form of green intervention, aimed at alleviating water shortages. Household WTP to reduce annual water shortage by one day varied between $0.85 (95% CI = 0.77-0.94) and $1.32 (95% CI = 1.08-2.56) per month depending on the project. The results also indicated that households were willing to pay $2.28 (95% CI = 1.36-3.21) and $3.51 (95% CI = 2.57-4.44) per month to increase forest cover in the watershed by 140-180 and 300-340 ha, respectively, assuming no additional water provision from the reforestation project. Nonwater-related benefits comprised 25-34% of the WTP for green intervention, depending on the acreage scenario. We also observed that, even without the nonwater-related ecosystem service benefits associated with reforestation, the value of water from green intervention exceeded the corresponding value of water from gray intervention. The disparity between preferences for water obtained from gray and green intervention may be due to differences in corresponding timing, uncertainty, quality of additional water made available from the considered projects, and differences in value elicitation methods.

Willingness to give amid pandemics: a contingent valuation of anticipated nongovernmental immunization programs

Given that altruism is crucial in assisting impoverished households to cope with health and economic crises, it is important to improve our understanding of how preferences and motives for giving differ during a pandemic. We implemented a web-based, contingent valuation survey to estimate Americans' willingness to give for nongovernmental immunization programs in the context of the COVID-19 pandemic. Our results indicate that the median person is willing to give a one-time donation of $26, or at least $13 when willingness-to-give estimates are corrected for uncertainty regarding future donations. We find that willingness to give is related to income, concern levels, vaccine usage, and sociodemographic characteristics. Our findings also shed light on purely and impurely altruistic motives underlying the willingness to fund immunization programs.

Parental acceptance and willingness to pay for a newly designed kitchen rack to reduce paediatric burns

The majority of pediatric burns in Mongolia occur within the home, particularly in the spaces dedicated to cooking. This makes home environment modification a priority for injury prevention. Many of these injuries are caused by electric appliances used in traditional tent-like dwellings (called a ger). In the present study, we designed and provided a context appropriate kitchen rack to 50 households with children aged 0-3 years living in gers and investigated parental views on the acceptability of the rack and willingness-to-pay (WTP) through face-to-face structured individual and group interviews and the contingent valuation method. We used the DCchoice package of R to estimate the median WTP and its 95% confidence interval by the household income, previous experience of childhood burn injury, and the number of children in the household. There was a total of 89 children aged <5 years in the 50 households, with a total of 59 burn experiences since birth including 29 treated at inpatient facilities. The median WTP was MNT 106,000 (about USD 37). The WTP appeared to be higher for the households with a higher income, more severe child burn experiences, and a greater number of children in the household. In the group interviews conducted after 4-6 weeks of routine use, the participants indicated that the use of the rack had resulted in a less stressful cooking environment, and the kitchen rack was described as a positive contribution to the reduction of risk to their young children. Whilst there were some suggestions for minor modifications, the rack was well accepted as a means of child burn prevention by the parents of infants and toddlers in Mongolia.

Households' willingness to pay for the rehabilitation of wetlands: evidence from Gudera Wetland, Northwest Ethiopia

Gudera wetland is accredited as a home for innumerable goods and services that have economic value for individuals living around and outside them. However, due to the absence of rehabilitation intervention, the wetland is at the edge of collapse at this time. This paper aims to: (1) estimate households' mean willingness to pay (WTP) for the rehabilitation of the wetland, (2) investigate determinants that affect the probability and intensity of WTP, and (3) estimate aggregated welfare gains from the intervention. To address these objectives, data from 237 household heads were collected using a two-stage random sampling procedure. For the analysis, econometric models, such as bivariate probit and double hurdle, were employed to estimate the mean WTP and determinants of WTP, respectively. The result demonstrates that the mean WTP value from the double bounded dichotomous choice ranges from 70.44 to 80.64 Ethiopian Birr per year per household. Likewise, the aggregated welfare gain expected from the rehabilitation intervention ranges from 2,464,977 ($85,589) to 2,821,916 ($97,983) Ethiopian Birr per year. The double hurdle model result revealed that participation in natural resource conservation, frequency of extension contact and trust in budget allocation have a positive and significant effect on households' WTP. Whereas, factors, such as land size around the wetland, distance to the wetland and credit utilization have a negative influence on households’ WTP. These findings suggest that most of the sampled households are willing to contribute for the rehabilitation intervention and this could have implications for the success of future implementation.

The costs of celiac disease: a contingent valuation in Switzerland

This paper proposes a first monetary measure of the private costs of celiac disease, including intangible costs (physical symptoms, logistical constraints, etc.) in Switzerland. This auto-immune disease damages the intestine when patients ingest gluten. The only treatment currently available is a gluten-free diet, which implies great nutritional constraints. To get a monetary equivalent of the costs borne by celiac patients, we used a contingent valuation. The scenario suggested to celiac patients a treatment in form of a daily pill, which would allow them to eat normally and avoid any physical pain from celiac disease. Mean Willingness To Pay (WTP) for the treatment is found to be around CHF 87 (approx. USD 87) per month. WTP is positively influenced by direct and indirect costs of the disease. Oppositely, individuals, who find the gluten-free diet healthier are willing to pay less. Finally, unlike symptoms before diagnostic, the current presence or intensity of physical symptoms are found to be insignificant. The latter result can be explained by the fact that, individuals facing stronger symptoms are more likely to adhere strictly to the GFD and hence to reduce their frequency.

Personal attitudes and beliefs and willingness to pay to reduce marine plastic pollution in Indonesia

Marine plastic pollution (MPP) is one of the most pressing issues especially for fast-growing economies in the Global South where addressing it involves both government and personal actions to achieve effective waste management policies. Alternative modelling strategies accounting for personal traits and beliefs (latent attitudes) which are unobservable characteristics are frequently overlooked in policy assessment studies. This study combines contingent valuation and latent traits questions to derive the willingness of Indonesian respondents to support MPP mitigation initiatives. One and two-step models are compared to test the sensitivity of results to modelling assumptions. Latent traits help to understand the willingness to pay (WTP) for MPP and one and two-step approaches produce comparable results. On average respondents are willing to pay £15, per person, per year to reduce MPP, or 2% of the average monthly salary. Local and international organizations should consider motivations and latent traits when designing MPP mitigation strategies.

Households' willingness to pay and preferences for improved cook stoves in Ethiopia

This paper examines households' preferences, willingness to pay, and determinants of adopting improved cook stoves in rural Ethiopia. The study uses primary household data selected randomly from three districts in Ethiopia's Oromia region. The data was collected using a mix of contingent and choice experiment methods of valuation. The former used a double-bounded value elicitation method, while the latter used a fractional factorial design to efficiently generate an attribute and level combination for the improved cook stoves. The study also used various discrete choice models for data analysis and also used models which account for scale and preference heterogeneity. The findings show that the sample households were aware of the effects of using traditional cook stoves and the benefits of using improved cook stoves. However, they were constrained by the availability of the new technology and discouraged by the low-quality of the products that they had used so far. The estimated mean willingness to pay ranged from about 150 Birr to 350 Birr which is lower than the market price of the improved cook stoves. Emission reduction, reducing fire risks, and the durability of the cook stove positively affected its adoption, while price discouraged its use. Higher levels of education, higher incomes, non-farm employment, and having more livestock increased the probability of adopting the new gas stoves. The study recommends that policymakers and product designers should use the mean willingness to pay and marginal rate of substitution for the different attributes as a benchmark for product design and pricing that fit households' preferences and ability to pay. The lower mean willingness to pay means that a public subsidizing policy is needed for effectively disseminating improved cook stoves in rural Ethiopia.

A preference for quality: Australian general public's willingness to pay for home and residential aged care

In Australia and many other countries internationally, aged care services are provided to older people in their own homes or residential care facilities. The majority of these services are funded by the federal government using taxpayer contributions from the general public. However, the monetary value Australians place on aged care services, and the factors that predict this value, have not been examined. We, therefore, sought to determine the general public's willingness to pay (WTP) for aged care services and examine which factors influence this WTP. A cross-sectional contingent valuation survey was administered to a nationally representative cohort of 10,285 Australians between September and October 2020 from the general population aged 18 years and over. Respondents were asked to indicate their WTP values for satisfactory and high-quality aged care services to be provided in the future. A two-part regression model was used to explain what factors explained variation in WTP. In total, 80% (61%) of respondents were willing to pay to access satisfactory (high) quality home care (counterpart figures for residential care were 64% (45%)). On average, respondents were willing to pay between $126 and $158 ($145 and $237) per week to receive satisfactory-quality (high-quality) home care and between $333 and $520 ($308 and $680) per week for satisfactory-quality (high-quality) residential care. Respondents were willing to pay an additional $120 per week on average to access high-quality aged care. Higher WTP values were generally associated with being younger, male, recent experience with aged care through a close family member accessing aged care and ability to pay. These results suggest general public support for payment of individual co-contributions to access aged care services in the future.

Solution-oriented research for paediatric burn prevention in Mongolia: An assessment of prevention tools

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We assessed a newly developed tool for child burn prevention in Mongolia.

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Mixed research methods were used for the assessment.

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Families with children reported that the tool reduces child burn risks.

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The tool was well accepted, hence context-appropriate.

Child burn injuries in Mongolia are often caused by electric cooking appliances used on the floor or low table in traditional tent-like dwellings (called a ger) which have no separate kitchen. To prevent these injuries, we developed a context-specific kitchen rack to make electric appliances inaccessible to children, and the rack was provided to 50 families with children aged 0–3 years living in gers for a pilot test. In the present study, we investigated their opinions about the rack after they used it for about 10 months through semi-structured interviews, their willingness-to-pay (WTP) for the rack using a contingent valuation method, and their preference for potential modifications of the rack using best–worst scaling. The estimated median WTP was about USD 40 (which was higher than USD 37 at the baseline when they started to use the rack). The highest priority of modifications of the rack was to enclose the lower section of the rack with doors (which was originally open without doors to reduce the production cost). A few families did not use the rack in winter because they used heating stoves instead of electric appliances for cooking, but we found a unanimous view that the rack reduces burn injuries to children, which may be reflected in their increased WTP for the rack. These findings would guide us to make our burn prevention efforts more relevant to real-life situations and socially acceptable in Mongolia.

Comparing the monetary value of a quality-adjusted life year from the payment card and the open-ended format

BACKGROUND

The payment card (PC) format and the open-ended (OE) format are common methods in eliciting willingness-to-pay (WTP) of one additional quality-adjusted life year (QALY). The aim of this research is to compare these two formats in eliciting the monetary value of a QALY.

METHODS

A contingent valuation survey was carried out using a pre-designed questionnaire with various hypothetical scenarios. The difference between the PC and the OE formats was evaluated by a two-sample equality test. Furthermore, generalized linear models were carried out to control observed heterogeneity and to test theoretical validity.

RESULTS

In total, 461 individuals were involved, among whom 235 (51%) answered the PC question, while 226 (49%) answered the OE question. Excluding zero response, the mean WTP values of these two formats for different scenarios varied dramatically, which was from 13,278 to 280,177 RMB for the PC, 18,119 to 620,913 RMB for the OE. The OE format tended to elicit lower values for less serious condition and higher values for more serious condition. However, equality test of mean and median demonstrated insignificant difference of these two formats for all scenarios. For both OE and PC format, most variables were found to have significant effect on the value of WTP/QALY. Moreover, joint estimation indicated a statistically significant positive effect on the OE results. Further analysis demonstrated that the imbalanced zero response distribution caused the main difference of these two formats.

CONCLUSIONS

This research indicated insignificantly different WTP/QALY estimates of the PC format and OE format with the grouped data whereas significantly higher estimates of the OE format from the pooled data. These two formats were found to be valid. More research about the difference and the validity of various WTP eliciting methods would be recommended for a robust estimation of WTP/QALY.

Environmental conservation value of an endangered species: the case of Cypripedium Japonicum

The South Korean government is seeking information on the environmental conservation value (ECV) of Cypripedium japonicum, a plant on the first-level priority endangered species list of the Korea Ministry of Environment, as well as on the Red List of the International Union for Conservation of Nature. This research paper aims to assess the ECV by employing contingent valuation (CV) to elicit people's willingness to pay (WTP) for its conservation. To achieve this aim, in May 2020, a CV survey of 1,000 interviewees in South Korea was carried out employing a closed-ended question. The average household WTP is estimated to be KRW 3,770 (USD 3.07) per annum and secures statistical significance. From a national point of view, using information on the national population, this value comes to KRW 76.72 billion (USD 62.42 million) per year. Although the cost of conserving the species has not yet been accurately estimated, the ECV seems to be larger than the cost of conservation. Thus, it is socially desirable to conserve Cypripedium japonicum, and the conservation should be carried out in a stable and continuous manner.

Risk aversion, trust in institutions and contingent valuation of healthcare services: trying to explain the WTA-WTP gap in the Dutch population

Background

The preferences of citizens are a basic element to incorporate into the decision-making process when planning health policies. Contingent valuation (CV) is a common method for calculating the value for citizens that new technologies, interventions, and the provision of services or policies have. However, choosing the correct CV tool may not be a neutral decision. This work aims to assess the substitution of a healthcare service by comparing valuation differences between the willingness to pay (WTP) for the maintenance of the service versus the willingness to accept compensation (WTA) for its substitution, both of which are related to subject characteristics, with a particular focus on trust in institutions and risk aversion.

Methods

A CV study was designed to study Dutch population preferences when physician assistants replace anaesthesiologists. Differences between the distributions of WTA and WTP were compared through full decomposition methods, and conditional quantile regression was performed.

Results

Nearly two-thirds of surveyed citizens expressed null values for WTA and WTP. The other third systematically reported a value of WTA higher than that of WTP, which increased further with lower income and the possible presence of a strategic bias. In contrast, being more than 65 years old, having trust in government, and preferring anaesthesiologists decreased the WTA-WTP difference. Risk aversion had no clear association with the WTA-WTP gap.

Conclusions

Known differences between the perceived value of health services from the perspective of gains and losses could be related to people’s characteristics. Trust in government but not aversion to risk was related to the WTA-WTP differences. Identifying a profile of citizens who are averse to losing health services should be considered when designing and implementing health services or interventions or making disinvestment decisions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12962-021-00281-9.

Willingness to join and pay for community-based health insurance and associated determinants among urban households of Cameroon: case of Douala and Yaounde

Background

The risks associated with direct health spending are high in Cameroon, where almost all household income is spent on health care. Moreover, there is no real social security in Cameroon because of the lack of a universal social protection system.

Objectives

This study aimed to assess the willingness of Cameroonian urban dwellers to subscribe and the amount to pay for voluntary (VCHI) or compulsory community-based health insurance (CCHI).

Methods

A cross-sectional study based on a three-stage stratified cluster random sampling design using a bidding game style based on the contingent valuation approach was performed to in the two largest urban areas of Cameroon (Douala and Yaoundé) evaluate the willingness to pay for the VCHI and CCHI.

Results

The results shown that 46% of respondent were willing to join the CCHI and 41% for VCHI. Furthermore, household income, working sector, chronic disease, health priority, and family size were factors mostly associated (p < 0.001) with the willingness to join CCHI or VCHI. Increase in household income has a positive effect on household's desire for both CCHI and VCHI. While for VCHI, increase of children number resulted in an increment of the premium, contrary to the occurrence of chronic ailment which led in the decrease of the bid.

Conclusions

From the results, it is clear that city dwellers in Cameroon are ready to join and pay for community health insurance. This willingness was related to their financial power which resulted in an average insurance premium of 9.03 USD and 8.17 USD, respectively for CCHI and VCHI. That bid was found to be enough for an implementation of these types of health insurance in Cameroon.

Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh

As the world's longest running pandemic, cholera poses a substantial public health burden in Bangladesh, where human vulnerability intersects with climatic variability. Barriers to safe water and sanitation place the health of millions of Bangladeshis in jeopardy - especially those who have highly constrained choices in preventing and responding to cholera. In this paper we investigate demand for cholera prevention among residents in the Mirpur and Karail slum areas of urban Dhaka. Using survey data from 2023 households in two slum areas, we analyze responses from a contingent valuation questionnaire that elicited willingness to pay (WTP) for cholera vaccines across household members and under varying disease risk scenarios, finding higher valuation for cholera prevention for children and under scenarios of greater epidemic risk. We estimate the average WTP for a cholera vaccine for a child ranges from TK 134-167 (US$ 1.58-1.96). Consistently, respondents with prior knowledge of the cholera vaccine reported lower WTP valuations, providing suggestive evidence of concerns about vaccine effectiveness and preferences for cholera treatment over prevention. We supplement the contingent valuation analysis with cost of illness estimates from both our household sample as well as from administrative hospital records of over 34,000 cholera patients. We estimate that a household incurs costs of TK 801-922 (US$ 9.43-10.50) per episode of cholera that requires medical treatment. Taken together, these findings indicate higher WTP for cholera treatment compared to prevention, but increased interest in prevention under early warning system scenarios of high disease risk.

Willingness to pay for private health insurance among workers with mandatory social health insurance in Mongolia

Background

High out-of-pocket health expenditure is a common problem in developing countries. The employed population, rather than the general population, can be considered the main contributor to healthcare financing in many developing countries. We investigated the feasibility of a parallel private health insurance package for the working population in Ulaanbaatar as a means toward universal health coverage in Mongolia.

Methods

This cross-sectional study used a purposive sampling method to collect primary data from workers in public and primary sectors in Ulaanbaatar. Willingness to pay (WTP) was evaluated using a contingent valuation method and a double-bounded dichotomous choice elicitation questionnaire. A final sample of 1657 workers was analyzed. Perceptions of current social health insurance were evaluated. To analyze WTP, we performed a 2-part model and computed the full marginal effects using both intensive and extensive margins. Disparities in WTP stratified by industry and gender were analyzed.

Results

Only < 40% of the participants were satisfied with the current mandatory social health insurance in Mongolia. Low quality of service was a major source of dissatisfaction. The predicted WTP for the parallel private health insurance for men and women was Mongolian Tugrik (₮)16,369 (p < 0.001) and ₮16,661 (p < 0.001), respectively, accounting for approximately 2.4% of the median or 1.7% of the average salary in the country. The highest predicted WTP was found for workers from the education industry (₮22,675, SE = 3346). Income and past or current medical expenditures were significantly associated with WTP.

Conclusion

To reduce out-of-pocket health expenditure among the working population in Ulaanbaatar, Mongolia, supplementary parallel health insurance is feasible given the predicted WTP. However, given high variations among different industries and sectors, different incentives may be required for participation.

Evaluating rural participation in wetland management: A contingent valuation analysis of the set-aside policy in Iran

Growing conditions of water scarcity and population growth necessitate measures for improved water availability to meet agricultural, industrial, and domestic and consumer water demands; generating new environmental pressures on wetlands and other aquatic ecosystems. In Iran, the "set-aside program" incentivizes farmer participation in wetland conservation through mandated land management practices, making them key stakeholders in environmental conservation action. This study explores attitudes to participation in the set-aside wetland conservation program to revive the Jazmurian wetland in Iran, using a random sample of 226 farmer-stakeholder respondents. Farmers were surveyed to investigate economic and social participation using a willingness to accept (WTA) and willingness to pay (in money per ha) (WTP) model. Results show strong (45%) respondent opposition to wetland conservation participation. On the basis of their WTA, the amount of compensation offered by the villagers was significantly affected by "the cultivated area", "gender", "education", "family size", "residency", "income", "moralism", and "Inverse Mills Ratio index" factors. Also, "the cultivated area", "age", "education", "marital status", "family size", and "income" were found to be significantly affecting their WTP. We argue firstly, that policies to improve wetland conservation must join together infrastructure and agricultural development planning - such that dam projects, agricultural and water conservation planning are better integrated across wetland catchments. Secondly, that wetland conservation participation will be improved through land consolidation agreements for small-holders, and through incomes stabilization, capacity building, social learning and awareness-raising initiatives for farmers towards sustainable agricultural practices.

Indian dairy farmers' willingness to pay for sexed semen

Sexed semen is one of the newest reproductive technologies available for dairy farmers and can fulfil their desire to produce a high percentage of female calves. The present study was designed to define the willingness of Indian dairy farmers to pay for sexed semen. Hence, 120 small holder dairy farmers and 90 commercial dairy farmers were randomly selected from Karnal and Yamunanagar districts in North-western Haryana, where there is a high proportion of crossbred dairy cattle. Willingness to pay for sexed semen was evaluated by a contingent valuation method and its determinants by an interval regression model. The majority of the small holder dairy farmers (81.67%) were willing to pay for sexed semen and they were ready to pay around INR 340 per sexed semen straw. Almost all (99%) of the commercial dairy farmers were willing to pay around INR 770 per sexed semen straw, i.e. more than double the value identified by small holder dairy farmers. Among all the predictors fitted in the interval regression model to explain the willingness to pay for sexed semen by the commercial dairy farmers, namely education level, herd size and attitude towards public extension systems, were positive and significant contributors. Our findings may help to identify what subsidy is required to promote sexed semen among dairy farmers, and as a consequence further improve breeding policies by introducing this new livestock production technology with the active participation of the dairy farmers.

The value of COVID-19 tests in Latin America

Testing is a crucial strategy to control the spread of a pandemic. Voluntary participation in this strategy will depend on individual preferences towards and willingness-to-pay (WTP) for test results. We distributed a web-based, contingent valuation survey to social-media users in 16 Latin American countries to evaluate regional attitudes towards the emerging COVID-19 outbreak and WTP for COVID-19 testing. We observe that the cost of the test and household income are important determinants of testing intentions. We find higher WTP among those reporting greater concern relative to the average respondent. Accounting for uncertainty, our results indicate a WTP of approximately $45 dollars or 4.2 % of monthly income among respondents. These results, paired with our predicted participation rate of between 84-94 % for a $1 test, suggest that local officials will be able to effectively recruit participation in this mitigation strategy given the appropriate subsidization structure.

A contingent valuation approach to estimating the recreational value of commercial whale watching - the case study of Faxaflói Bay, Iceland

There is currently limited knowledge concerning the economic value of commercial whale watching from the perspective of the consumer's trip experience. This study outlines the results of an in-person contingent valuation survey, which asked whale watching tourists in Faxaflói Bay, Iceland, how much they would have been willing to pay beyond the paid ticket price. Based on a sample of 163 tourists, only 30 (18.40%) reported any consumer surplus, despite the majority stating positive satisfaction with the experience. Mean consumer surplus was 768 ISK (approximately 5.60 euros). Scaled up to the number of whale watching tourists in Faxaflói Bay in 2018 of 148,442, aggregate CS was approximately 114.0 million ISK (0.83 million euros), a 6.9% mark-up on estimated annual revenue generation derived from average ticket prices. The study provides new information on the economic value of whale watching in an area which had already been part-designated as a whale sanctuary.

What do we know about public acceptance of designating marine protected area? The case of Jaran Bay in South Korea

The South Korean Government is considering designating Jaran Bay, the habitat of the endangered marine species, Neophocaena asiaeorientalis, as a marine protected area. The Government needs information about public acceptance and the economic benefits of the designation. To unveil the information, this article aims to examine the public willingness to pay (WTP) using a contingent valuation based on a nationwide survey of 1000 households. As a WTP elicitation method, the one-and-one-half-bounded question format of asking an interviewee whether she/he has the intention of paying a presented bid through annual income tax was adopted. The WTP for the designation was statistically significantly estimated to be KRW 2665 (USD 2.27) per year per household. The estimate of the annual national value amounted to KRW 53 billion (USD 45.30 million). This value is by no means small, but it would take a huge amount of effort to elicit public consensus on the designation considering that a significant proportion of respondents (64.4%) revealed zero WTP.

Willingness-to-pay and willingness-to-accept of informal caregivers of dependent elderly people in Shanghai, China

BACKGROUND

In order to make optimal long-term care-related decisions, it is important to take a societal perspective. Shanghai is one of the pilot cities of social long-term care insurance in China. However, little knowledge exists about the economic value of the informal care provided to dependent elderly people in China. This paper aims to evaluate the economic value of informal caregiving in Shanghai using the contingent valuation method by their least-preferred care tasks, and identify the associated factors of willingness-to-pay (WTP) and willingness-to-accept (WTA) of the informal caregivers.

METHODS

This study employed the contingent valuation method to elicit 371 informal caregivers' WTP and WTA for 1 hour of reduction or increase of least-preferred caring tasks in Shanghai. Univariate and multivariate analyses were conducted to explore the associated factors with the WTP and WTA values.

RESULTS

The average WTP and WTA were 25.31 CNY and 38.66 CNY, respectively. The associated factors with WTP include caregiver's income and caregiver's relationship to the recipient. Care recipient's age, income, least-preferred task by the caregiver, and subscales of Caregiver Reaction Assessment were found to be associated with WTA. The non-responsiveness rates were 26.1 and 33.2% for WTP and WTA questions, respectively.

CONCLUSIONS

The findings of the current study demonstrated that decision-makers and researchers should take the economic valuation results of informal care into account to make more informed and effective long-term care-related policies and analyses.

Willingness to pay for an early warning system for infectious diseases

Early warning systems for infectious diseases and foodborne outbreaks are designed with the aim of increasing the health safety of citizens. As a first step to determine whether investing in such a system offers value for money, this study used contingent valuation to estimate people's willingness to pay for such an early warning system in six European countries. The contingent valuation experiment was conducted through online questionnaires administered in February to March 2018 to cross-sectional, representative samples in the UK, Denmark, Germany, Hungary, Italy, and The Netherlands, yielding a total sample size of 3140. Mean willingness to pay for an early warning system was €21.80 (median €10.00) per household per month. Pooled regression results indicate that willingness to pay increased with household income and risk aversion, while they decreased with age. Overall, our results indicate that approximately 80-90% of people would be willing to pay for an increase in health safety in the form of an early warning system for infectious diseases and food-borne outbreaks. However, our results have to be interpreted in light of the usual drawbacks of willingness to pay experiments.

Contingent assessment of the COVID-19 vaccine

The COVID-19 pandemic has not only had a negative impact on people's health and life behavior, but also on economies around the world. At the same time, laboratories and institutions are working hard to obtain a COVID-19 vaccine, which we hope will be available soon. However, there has been no assessment of whether an individual and society value ​​a vaccine monetarily, and what factors determine this value. Therefore, the objective of this research was to estimate the individual's willingness to pay (WTP) for a hypothetical COVID-19 vaccine and, at the same time, find the main factors that determine this valuation. For this, we used the contingent valuation approach, in its single and double-bounded dichotomous choice format, which was based on a hypothetical market for a vaccine. The sample used was obtained through an online survey of n = 566 individuals from Chile. The main results showed that the WTP depends on the preexistence of chronic disease (p≤0.05), knowledge of COVID-19 (p≤0.05), being sick with COVID-19 (p≤0.05), perception of government performance (p≤0.01), employment status (p≤0.01), income (p≤0.01), health care (p≤0.05), adaptation to quarantine with children at home (p≤0.01) and whether the person has recovered from COVID-19 (p≤0.10). According to our discrete choice model in double-bounded dichotomous format, it was concluded that the individuals' WTP is US$184.72 (CI: 165.52-203.92; p < 0.01). This implies a social valuation of approximately US$2232 million, corresponding to 1.09% of the GNP per capita.

Mothers' willingness to accept and pay for vaccines to their children in western Iran: a contingent valuation study

Background

The clients’ willingness to accept (WTA) and willingness to pay (WTP) for a given good or service can help elicit the monetary value of that good or service. This study aims to assess the WTA and WTP of mothers attending primary health centers for vaccines to their children during 2019 in Kermanshah city, western Iran.

Methods

We conducted a cross-sectional study on a total of 667 mothers attending primary health centers for vaccines to their children aged two to 18 months. A multistage sampling technique was employed to involve the mothers in the study, and data were collected using a self-administrated open-ended questionnaire. The multivariate linear regression model was used to identify the factors associated with the mothers’ WTP and WTA for vaccines to their children.

Results

The study indicated that 94.2 and 93.1% of the mothers respectively had WTA and WTP values greater than zero, with their corresponding mean values of US$ 6.8 and US$ 4.4. The mothers in the higher monthly household income category, mothers born in the urban areas, and being a female child showed statistically significant positive associations with the mothers’ WTA for the vaccines. While there was a statistically significant positive relationship between monthly household income and the mothers’ WTP; a statistically significant negative relationship exists between the mothers’ age and their WTP for the vaccine to their children.

Conclusions

The findings indicated the mothers’ WTA to WTP ratio of greater than one for the vaccines to their children. The most important factor associated with the mothers’ WTA and WTP was the monthly household income. Thus, improving the socio-economic standards of women in the study area might contribute to reinforcing their immunization services seeking behavior to their children.

Valuing the Cancer Mortality Risk Reduction from Lowering the Arsenic Maximum Contaminant Level in New Hampshire Municipal Water Supplies

This study uses a 2018 stated preference survey to elicit a willingness to pay (WTP) to reduce the cancer morbidity and mortality risk from arsenic exposure through drinking water. Respondents who use a public water supply are willing to pay $35.43 per month for the risk reduction associated with lowering the maximum allowable level of arsenic in drinking water from 10 to a hypothetical level of 3 ppb; households on private wells are willing to pay $29.19. Respondents from households with children were willing to pay significantly more than respondents from households without children. We derive values of a statistical life (VSL) of $4.61 million and $3.48 million per household member, respectively, in households using municipal or well water. Shortly after the initial release of these findings, New Hampshire became the second state to set a maximum allowable level for arsenic below the national limit of 10 ppb.

Participation in agri-environmental schemes: A contingent valuation study of farmers in Ireland

Agri-environment schemes (AES) are an important part of agricultural policy within Europe. They seek to achieve important goals with regards to biodiversity and the protection of natural resources while also helping to maintain culturally important landscapes and agricultural practices. Participation rates have been an important area of research into assessing the success of AES. Within Ireland and more broadly across Europe, systematic non-participation in AES has been observed. Certain farm and farmer types have been found more likely to participate. In this paper a contingent valuation exercise is conducted that assesses how AES payment levels impact on the participation decision of farmers. A bivariate probit with sample selection is utilised to account for farmers who are unwilling to participate regardless of payment levels. This allows for a more accurate estimation of farmer willingness-to-accept to participate in the hypothetical AES presented. It also offers insight into the characteristics of farmers who are unlikely to ever participate in these schemes. From the results it appears a significant proportion (30%) of farmers are unlikely to ever participate in AES, with the remaining open to participation depending on the compensation offered. It is argued that increased compensation levels may increase participation rates among some farmers who to date have been unlikely to participate.

Pollution exposure and willingness to pay for clean air in urban China

Rapid industrialization and urbanization are often accompanied by deteriorating air quality that imposes substantial health and productivity costs on the local population. However, existing studies have generally found low marginal willingness to pay (WTP) for mitigating such damages. To understand the determinants and the extent of WTP for air quality improvements, we collected comprehensive socio-demographic and stated preference information from more than 3000 random respondents in three cities in China. Combining the survey data with air quality data from ground-level monitoring stations, we find that exposure to persistent air pollution is a significant determinant of the extent individuals are willing to pay for cleaner air. On average, urban residents are willing to pay 65 CNY (~10 USD) each year to improve air quality to World Health Organization standards. Males and individuals that are younger and more educated tend to have higher WTP. We also find that individuals with more knowledge of sustainability and who engage in more pro-environmental behaviors are willing to pay more. Compared to existing government monetary incentives to reduce air pollution, the public's total WTP for cleaner air is much higher. Overall, these results highlight the potential welfare gain for policymakers to implement more stringent air quality regulations to reduce pollution.

Smallholder farmers' willingness to pay for scale-appropriate farm mechanization: Evidence from the mid-hills of Nepal

This paper analyzes smallholder farmers' willingness to pay (WTP) for the purchase of scale-appropriate farm mechanization in the hill ecologies of Nepal using the case of mini-tiller technology: a small, 5-7 horsepower two-wheel tractor primarily used for agricultural land preparation. Using primary survey data from 628 randomly-selected households, we find that farm size, local wage rates, out-migration, access to credit services, and associations with agricultural cooperatives positively influence the WTP for mini-tillers while the number of draft animals owned negatively influence the WTP for mini-tillers. On average, farmers were willing to pay 31% less than the actual price of a mini-tiller. Results also exhibited a heterogeneous demand in which the lowest quartile farm size households, typically the poorest farm households, were willing to pay 26% less for the mini-tiller than the top quartile of farms. In the context of labor scarcity and rising rural wages, agricultural policy on farm mechanization in Nepal should aim to prioritize small farms through robust service provision models in order to increase the level of farm mechanization in the country.