Health Economics, Policy and Law

Debate

Contingent valuation: what needs to be done?

Richard D. Smitha1 c1 and Tracey H. Sacha2

a1 Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK

a2 School of Chemical Sciences and Pharmacy and Health Economics Group, University of East Anglia, Norwich, UK

Abstract

Contingent valuation (CV) has been argued to have theoretical advantages over other approaches for benefit valuation used by health economists. Yet, in reality, the technique appears not to have realised these advantages when applied to health-care issues, such that its influence in decision-making at national levels has been non-existent within the health sector. This is not a result of a lack of methodological work in the area, which has continued to flourish. Rather, it is a result of such activities being undertaken in a rather uncoordinated and unsystematic fashion, leading CV to be akin to a ‘ship without a sail’. This paper utilises a systematic review of the CV literature in health to illustrate some important points concerning the conduct of CV studies, before providing a comment on what the remaining policy and research priorities are for the technique, and proposing a guideline for such studies. It is hoped that this will initiate some wider and rigorous debate on the future of the CV technique in order to make it seaworthy, give it direction and provide the right momentum.

Correspondence:

c1 Correspondence to: Richard D. Smith, Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: Richard.Smith@lshtm.ac.uk