Liljas B, Blumenschein K
Program on Economic Evaluation of Medical Technology, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA.
Health Policy. 2000 May;52(1):53-70. doi: 10.1016/s0168-8510(00)00067-1.
Despite a sound foundation in economic welfare theory, willingness to pay (WTP) has not been used as a measure of benefits in economic evaluations of health and health care to the same extent as in other fields. Some have suggested that this is due to non-economists' reluctance to placing dollar values on the benefits of health care. However, another potential reason could be uncertainties about the validity of the WTP measure. In this paper, we outline the bias problems with the WTP method, and specifically focus on hypothetical bias; i.e. whether the WTP from hypothetical elicitation methods overstates the real WTP or not. This is done by examining the literature in this field, with emphasis on economic experiments where there is a greater possibility for comparison. The findings are that hypothetical WTP in general significantly overestimates real WTP, but that calibration methods to reduce or eliminate this difference are currently being developed. We conclude that while the area is still very much under development, there seem to be reasons to view the use of cost-benefit analysis as a reasonable alternative to the more common cost-effectiveness analysis.
尽管经济福利理论有坚实的基础，但支付意愿（WTP）在卫生与医疗保健的经济评估中，并未像在其他领域那样，被广泛用作衡量效益的指标。一些人认为，这是因为非经济学家不愿为医疗保健的效益赋予货币价值。然而，另一个潜在原因可能是支付意愿衡量方法的有效性存在不确定性。在本文中，我们概述了支付意愿方法存在的偏差问题，并特别关注假设偏差；即通过假设性诱导方法得出的支付意愿是否高估了真实的支付意愿。我们通过研究该领域的文献来进行分析，重点关注那些更具可比性的经济实验。研究结果表明，一般而言，假设性支付意愿会显著高估真实支付意愿，但目前正在开发一些校准方法以减少或消除这种差异。我们的结论是，尽管该领域仍在大力发展，但似乎有理由认为，将成本效益分析作为更常用的成本效果分析的合理替代方法是可行的。
