Valuing health care using willingness to pay: a comparison of the payment card and dichotomous choice methods

This paper compares willingness to pay (WTP) estimates generated from the dichotomous choice (DC) and payment card (PC) approaches. In a split-sample WTP experiment concerned with allocating scarce health care resources across three health care interventions, the DC approach is shown consistently to generate larger welfare estimates than the PC. Observed difference between PC and DC experiments cannot be explained by the inclusion of non-demanders or methods of statistical analysis but may be partly explained by "yea-saying". No evidence of range bias or mid-point bias was found with PC responses. Data were also collected on respondents' ordinal rankings of the three interventions and person-trade-offs (PTOs). Neither of these approaches converged with WTP. Future work must address the decision heuristics individuals employ when responding to valuation experiments.