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How You Ask Is What You Get: Willingness-to-Pay for a QALY in Germany

Author

Listed:
  • Marlies Ahlert
  • Friedrich Breyer
  • Lars Schwettmann

Abstract

We report results of a survey of a representative sample of the German population in which respondents were asked for their willingness-to-pay (WTP) for either an extension of their life or an improvement in their health corresponding to a gain of one quality-adjusted life year (QALY). While one version of the survey exactly copied the questionnaire used in the EuroVaQ project (Pennington et al. 2014), in other versions the wording and the survey technique were modified. The findings show first that Germans have no higher WTP for health gains than other Europeans. Second, the technique of posing the questions plays an important role when respondents are asked to imagine being in hypothetical situations. This clearly refers to the wording of the questions and the survey setting (personal or online interview). But even simple design elements such as offering an explicit option to say “No” right away greatly affect the answers, as does the position in the questionnaire that a particular question is given. This shows that in any attempts to base health care rationing decisions on the WTP of the population, where the latter is to be elicited using surveys, great care must be taken in designing the questionnaires.

Suggested Citation

  • Marlies Ahlert & Friedrich Breyer & Lars Schwettmann, 2014. "How You Ask Is What You Get: Willingness-to-Pay for a QALY in Germany," Discussion Papers of DIW Berlin 1384, DIW Berlin, German Institute for Economic Research.
    • Handle: RePEc:diw:diwwpp:dp1384
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    File URL: https://www.diw.de/documents/publikationen/73/diw_01.c.465601.de/dp1384.pdf
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    References listed on IDEAS

    as
    1. Friedrich Breyer, 2013. "Implicit Versus Explicit Rationing of Health Services," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(01), pages 07-15, April.
    2. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    3. Hammitt, James K & Graham, John D, 1999. "Willingness to Pay for Health Protection: Inadequate Sensitivity to Probability?," Journal of Risk and Uncertainty, Springer, vol. 18(1), pages 33-62, April.
    4. Cragg, John G, 1971. "Some Statistical Models for Limited Dependent Variables with Application to the Demand for Durable Goods," Econometrica, Econometric Society, vol. 39(5), pages 829-844, September.
    5. Friedrich Breyer, 2013. "Implicit Versus Explicit Rationing of Health Services," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(1), pages 07-15, 04.
    6. repec:ces:ifodic:v:11:y:2013:i:1:p:19078505 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Willingness to Pay; QALY; Survey; Germany; EuroVaQ;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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