Willingness to pay for diagnostic technologies: a review of the contingent valuation literature.
OBJECTIVE
To understand how people value information from diagnostic technologies, we reviewed and analyzed published willingness-to-pay (WTP) studies on the topic.


METHODS
We searched PubMed for English-language articles related to WTP for diagnostic laboratory tests published from 1985 through 2011. We characterized methodological differences across studies, examined individual- and technology-level factors associated with WTP, and summarized median WTP values across different diagnostic tests.


RESULTS
We identified 66 relevant WTP studies. Half focused on oncology, while others analyzed infectious diseases (n = 11, 16.1%) and obstetric or gynecological conditions (n = 8, 11.7%), among others. Most laboratory tests included in studies were biological samples/genetic testing (n = 44, 61.1%) or imaging tests (n = 23, 31.9%). Approximately one third of the analyses (n = 20, 30.3%) used discrete-choice questions to elicit WTP values. Higher income, education, disease severity, perceived disease risk, family history, and more accurate tests were in general associated with higher WTP values for diagnostic information. Of the 44 studies with median WTP values available, most reported a median WTP value below $100. The median WTP value for colon or colorectal cancer screening ranged from below $100 to over $1000.


CONCLUSIONS
The contingent valuation literature in diagnostics has grown rapidly, and suggests that many respondents place considerable value on diagnostic information. There exists, however, great variation in studies with respect to the type of technologies and diseases assessed, respondent characteristics, and study methodology. The perceived value of diagnostic technologies is also influenced by the study design and elicitation methods.
Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA. plin@tuftsmedicalcenter.org
Pei-Jung
PJ
Lin
Michael J
MJ
Cangelosi
David W
DW
Lee
Peter J
PJ
Neumann
D002755:Choice Behavior; D003365:Costs and Cost Analysis; D019937:Diagnostic Techniques and Procedures / Q000191:economics*; D005382:Financing, Personal / Q000191:economics*; D018803:Models, Economic; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
contingent valuation; diagnostics; review; willingness to pay