3131.0: Monday, October 22, 2001 - 3:00 PM

Abstract #31601

Perceptions of risks and benefits: Impact on valuations of health-care treatments and prevention interventions

Martin I. Meltzer, PhD, Office of Surveillance, Office of the Director, Centers for Disease Control and Prevention, National Center for Infectious Diseases, Mailstop D-59, 1600 Clifton Rd., Atlanta, GA 30333, 404-371-5353, Mmeltzer@cdc.gov

Different perspectives can create different valuations. For example, prison wardens are unlikely to save money (i.e., have a budgetary incentive) by routinely vaccinating incoming prisoners against hepatitis B. Society would save money if all incoming inmates were vaccinated. Perspective-related differences, however, have no pattern. Routinely vaccinating restaurant workers against hepatitis A will not save resources for either restauranteurs or society. Even with a single perspective, different "yardsticks" can produce different results. From a societal perspective, deciding who should first receive potentially scarce supplies of pandemic influenza vaccine will depend upon the criteria used. Risk-of-death criterion will place persons aged 65+ years as the top priority to be vaccinated. Using economic returns to vaccination as the criterion will place those aged 20-64 years as the top priority. Even using a single perspective and valuation criterion can produce uneven preference orderings (i.e., valuation), violating basic economic theory. For example, during a willingness-to-pay (WTP) study, increasing the stated effectiveness of oral raccoon rabies vaccine did not result in a logical increase in valuation. Similarly, in another WTP study on Lyme disease vaccine, increasing stated effectiveness did not cause respondents to increase valuations. Recent work has demonstrated that even the method used to present risks and effectiveness of interventions can influence preference orderings. Mathematical literacy can, therefore, impact valuations. These are some, but not, all the reasons why valuations of health care interventions are unlikely to have a "single voice." Any economic study should explicitly account for different perspectives and valuations of probabilities.

Learning Objectives: Participants will learn how different perspectives and probability valuations impact willingness to pay for preventive services.

Keywords: Economic Analysis, Prevention

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA