Willingness to pay for remote and self-monitoring: Comparing patients and non-patients in gestational hypertensive care

Abstract

Objectives: Contingent valuation (CV) is widely used in health economics, as it enables the quantification of diverse benefits within a single monetary measure. However, a key methodological debate that remains underexplored is whether patients or non-patients should complete the CV task and how this choice may influence willingness to pay (WTP) estimates. This study aimed to investigate that question in the context of two home blood pressure (BP) monitoring approaches for pregnant women at risk of gestational hypertensive disorders, remote monitoring (RM) and patient self-monitoring (PSM). We also examined the role of patient status and treatment experience in shaping WTP. Methods: The WTP of 199 patients and 222 non-patients was examined using a CV survey, combining a payment card and open-ended question. Propensity score matching analysis with regression adjustment assessed WTP differences between patients and non-patients. Subgroup analyses explored whether these differences were driven solely by being a patient or also by home BP monitoring experience. Results: The mean WTP was <euro>130 for RM and <euro>85 for PSM. Patients exhibited a <euro>31 higher WTP for RM compared to non-patients, a difference that was marginally significant at the 10 % level. This effect was driven by treatment experience status. We found no significant difference in WTP PSM between patients and non-patients. Conclusions: Simply being a patient does not affect WTP for home BP monitoring. When patients have treatment experience, this can increase WTP compared to non-patients, but not for approaches for which the potential benefits are apparent without experiencing them, like PSM.