| 1. |
- Johannesson, Magnus, et al.
(författare)
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From Principle To Public Policy: Using Cost-Effectiveness Analysis
- 1994
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Ingår i: Health Affairs. - : Health Affairs (Project Hope). - 1544-5208 .- 0278-2715. ; 13:3, s. 206-214
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Tidskriftsartikel (refereegranskat)abstract
- Medical technology assessment, which traditionally has involved evaluating whether a technology was safe and effective, has been expanded in recent years to include consideration of cost-effectiveness. While most analysts and policymakers would agree that cost-effectiveness is, in principle, a worthy goal, actually using such a standard in coverage decisions is much more difficult. This Commentary focuses on challenges involved for public payers and what we can realistically expect a cost-effectiveness criterion to accomplish. First, we briefly discuss the cost-effectiveness principle. Second, we address some of the key issues in asserting medical technologies. Finally, we discuss both the opportunities and limitations of cost-effectiveness analysis.
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| 2. |
- Neumann, Peter J., et al.
(författare)
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The Willingness to Pay for In Vitro Fertilization: A Pilot Study Using Contingent Valuation
- 1994
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Ingår i: Medical care. - : Lippincott-Raven Publishers. - 1537-1948 .- 0025-7079. ; 32:7, s. 686-699
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Tidskriftsartikel (refereegranskat)abstract
- The use of in vitro fertilization (IVF) has increased rapidly in recent years and debate has focused on whether health insurance should cover the procedure. We developed and disseminated a contingent valuation survey to investigate how individuals value IVF treatment. Couples pursuing in vitro fertilization can be viewed as purchasing an increased probability of conceiving and bearing a child. In our survey, respondents were asked if they would pay stated amounts for IVF, under various assumptions about the probability of success. The survey explores the ex post perspective, (respondentsʼ willingness to pay (WTP) for IVF in the event that they are infertile), the ex ante perspective, (WTP for IVF insurance, assuming respondents do not know their infertility status), WTP for a public IVF program, and how respondents value IVF relative to mortality risk reduction. Among 150 respondents who were potential childbearers, average WTP was $17,730 for a 10% chance at having a child through IVF in the event of infertility. Average WTP was $865 for a lifetime insurance benefit providing access to a 10% chance. Among 231 respondents of all ages, average WTP was $32 per year in taxes for a public program giving 1,200 couples per year in Massachusetts a 10% chance. The estimated implied ex post WTP per statistical baby was $177,730, while ex ante WTP per statistical baby was $1.8 million. The results of regression analyses were consistent with theoretical predictions, (e.g., increasing WTP with household income). The contingent valuation method is a potentially useful tool in understanding how people value the benefits of IVF. Further research is needed to test the validity of this methodology.
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