Eliciting preferences for resource allocation in health care

Willingness-to-pay (WTP) studies are increasingly being used in the evaluation of health care programmes and, although less frequently, for priority setting in health care. The usefulness of willingness-to-pay as a discriminatory tool for priority setting is considered in this paper for three different health care programmes in Ireland: cancer, cardiovascular and community care. While the resulting estimates are consistent with respondents' rankings of the programmes, there is no statistical difference among the three programmes in terms of WTP. In considering marginal changes to existing health care programmes people consider their rankings of the programmes and the existing capacity of each programme. People are also more concerned with the gains to themselves of expanding various health care programmes than with wider issues of access or fairness