Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 30, 2018
Date Accepted: Oct 12, 2018
(closed for review but you can still tweet)
Valuing Healthy Connections: Willingness-to-Pay Study of a National Digital Health Implementation Program
ABSTRACT
Background:
Changing population demographics and technology developments have resulted in growing interest in the potential of consumer-facing digital health. In the United Kingdom, a £37 million (US $49 million) national digital health program delivering assisted living lifestyles at scale (dallas) aimed to deploy such technologies at scale. However, little is known about how consumers value such digital health opportunities.
Objective:
This study explored consumers’ perspectives on the potential value of digital health technologies, particularly mobile health (mHealth), to promote well-being by examining their willingness-to-pay (WTP) for such health solutions.
Methods:
A contingent valuation study involving a UK-wide survey that asked participants to report open-ended absolute and marginal WTP or willingness-to-accept for the gain or loss of a hypothetical mHealth app, healthy connections.
Results:
A UK-representative cohort (n=1697) and a dallas-like (representative of dallas intervention communities) cohort (n=305) were surveyed. Positive absolute and marginal WTP valuations of the app were identified across both cohorts (absolute WTP: UK-representative cohort £196 [US $259] and dallas-like cohort £162 [US $214]; marginal WTP: UK-representative cohort £160 [US $211] and dallas-like cohort £151 [US $199]). Among both cohorts, there was a high prevalence of zeros for both the absolute WTP (UK-representative cohort 27.52% [467/1697] and dallas-like cohort 31.15% [95/1697]) and marginal WTP (UK-representative cohort 28.70% [487/1697] and dallas-like cohort 32.5% [99/305]). In both cohorts, better general health, previous amount spent on health apps (UK-representative cohort 0.64, 95% CI 0.27 to 1.01; dallas-like cohort 1.27, 95% CI 0.32 to 2.23), and age had a significant (P>.00) association with WTP (UK-representative cohort −0.1, 95% CI −0.02 to −0.01; dallas-like cohort −0.02, 95% CI −0.03 to −0.01), with younger participants willing to pay more for the app. In the UK-representative cohort, as expected, higher WTP was positively associated with income up to £30,000 or US $39,642 (0.21, 95% CI 0.14 to 0.4) and increased spending on existing phone and internet services (0.52, 95% CI 0.30 to 0.74). The amount spent on existing health apps was shown to be a positive indicator of WTP across cohorts, although the effect was marginal (UK-representative cohort 0.01, 95% CI 0.01 to 0.01; dallas-like cohort 0.01, 95% CI 0.01 to 0.02).
Conclusions:
This study demonstrates that consumers value mHealth solutions that promote well-being, social connectivity, and health care control, but it is not universally embraced. For mHealth to achieve its potential, apps need to be tailored to user accessibility and health needs, and more understanding of what hinders frequent users of digital technologies and those with long-term conditions is required. This novel application of WTP in a digital health context demonstrates an economic argument for investing in upskilling the population to promote access and expedite uptake and utilization of such digital health and well-being apps.
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