An overview of the methodological aspects and policy implications of willingness-to-pay studies in oral health: a scoping review of existing literature

Abstract

Background Demands for dental services seem to be beyond the capacities of most healthcare systems these days. Patient preferences have been increasingly emphasized to be considered in the joint decision-making process. Willingness-to-pay (WTP) is a recommended method for measuring the utility of health services; increasingly being used in recent decades. Taking these points into consideration, this article aims to provide an overview of the methodological aspects and policy implications of WTP studies in the field of oral health. Methods The research was conducted in ISPOR, PubMed and Google Scholar databases. In addition, reference lists of included articles were checked to identify the relevant studies. All studies published were included that were in the English language and reported using WTP for oral health-related goods and services. A data-charting form was developed by a focus group discussion panel of seven experts to derive the main methodological aspects of WTP. Also, Core policy suggestions were categorized through thematic content analysis of the included papers. Results The search strategy yielded 389 studies of which 52 were included. WTP studies in oral health show an increasing trend in global publications. The UK and Canada have a greater share in published material than in any other country. The dominant field of these researches is in restorative and prosthetic dentistry, and a wide range of different methodological aspects was documented. Policy suggestions were categorized in three main themes: (A) setting new tariffs or subsidizing the item, (B) provision of the item due to population preferences, and (C) improving literacy regarding the item. Conclusions An urgent need for a common framework regarding the design of WTP studies in dentistry seems paramount. Some policy suggestions seem not to be applicable, perhaps due to insufficient familiarity of the researchers with the complexities of the public policymaking process.

Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine

“…CV methods were first used in environmental economics to value goods or services for which no market and, hence, price exists [ 72 ]. However, it has been recognized that CV is also a useful methodology for valuing a commodity in healthcare and its use in medicine, and more recently, also in dentistry which has substantially increased in recent years [ 1 , 2 , 71 ]. CV studies usually elicit the preference of respondents by asking them how much they are willing to pay for a good or service using a variety of different questioning methods such as open-ended questions, bidding games or payment cards [ 3 , 12 , 73 ].…”

“…The search strategy for PubMed included the query: (“Willingness-to-pay” OR WTP OR “Willingness to accept” OR WTA OR “Contingent valuation” OR “Conjoint analysis” OR “Cost benefit analysis” OR “Discrete choice experiment” OR “Monetary value”) AND (Dentistry (MeSH) or “dent”). In addition, we hand-searched the references of two published systematic reviews on WTP estimates for dental interventions [ 1 , 2 ]. We also searched the Cochrane Library ( , accessed 8 June 2021) and the PROSPERO database ( , accessed 8 June 2021) for published or eventual ongoing studies that assessed WTP using CV as a stated preference method on 8 June 2021.…”

“…In times of increasing pressures to contain healthcare resource consumption, there is an increasing interest in valuing dental healthcare goods and services using economic methods such as contingent valuation (CV) [ 1 , 2 ]. CV studies assess the value of a commodity by asking the respondent the maximum in monetary terms he is willing to pay (WTP) to receive a good or service, or alternatively, the minimum he is willing to accept (WTA) to forgo the good or service offered [ 3 , 4 ].…”

“…CV studies assess the value of a commodity by asking the respondent the maximum in monetary terms he is willing to pay (WTP) to receive a good or service, or alternatively, the minimum he is willing to accept (WTA) to forgo the good or service offered [ 3 , 4 ]. CV studies were first used in environmental economics for valuing goods and services for which no free real-world market exists, but have then gained more attention in healthcare, and more recently, also in dental medicine [ 1 , 2 , 5 , 6 , 7 ]. Other economic methods for valuing health states and interventions such as the time-trade-off method or standard-gamble method allow one to estimate health state utilities that are often used to compute composite outcomes such as quality-adjusted life-years (QALYs), or more oral health-related outcomes such as quality-adjusted tooth-years (QATYs) or quality-adjusted prosthesis-years (QAPYs) [ 8 , 9 , 10 ].…”

Valuation of Local Demand for Improved Air Quality: The Case of the Mae Moh Coal Mine Site in Thailand

“…Furthermore, the repeated questioning may annoy or tire respondents, tempting them to say no (yes) to an ad-hoc amount for the purpose of ending the queries [54]. An alternative to address the limitations of the bidding approach is the payment card method, where researchers present a number of different values on different cards and ask the respondent to pick the amount that best represents his or her WTP [55]. Although this method can overcome the limitations of the bidding approach, it also has drawbacks as respondents might limit their WTP only to one of the values presented on the cards, or the WTP might be outside the range of the printed values [51,55].…”