Willingness to pay for health gains from an international integrated early warning system for infectious disease outbreaks

Meg Perry-Duxbury, Sebastian Himmler, Job van Exel*, Werner Brouwer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Downloads (Pure)


Recently, due to the corona virus outbreak, pandemics and their effects have been at the forefront of the research agenda. However, estimates of the perceived value of early warning systems (EWSs) for identifying, containing, and mitigating outbreaks remain scarce. This paper aims to show how potential health gains due to an international EWS might be valued. This paper reports on a study into willingness to pay (WTP) in six European countries for health gains due to an EWS. The context in which health is gained, those affected, and the reduction in risk of contracting the disease generated by the EWS are varied across seven scenarios. Using linear regression, we analyse this ‘augmented’ willingness to pay for a QALY (WTP-Q) for each of the scenarios, where ‘augmented’ refers to the possible inclusion of context specific elements of value, such as feelings of safety. An initial WTP-Q estimate for the basic scenario is €17,400. This can be interpreted as a threshold for investment per QALY into an EWS. Overall, WTP estimates move in the expected directions (e.g. higher risk reduction leads to higher WTP). However, changes in respondents’ WTP for reductions in risk were not proportional to the magnitude of the change in risk reduction. This study provided estimates of the monetary value of health gains in the context of a pandemic under seven scenarios which differ in terms of outcome, risk reduction and those affected. It also highlights the importance of future research into optimal ways of eliciting thresholds for investments in public health interventions.

Original languageEnglish
Pages (from-to)967-986
Number of pages20
JournalEuropean Journal of Health Economics
Issue number6
Early online date28 Sept 2022
Publication statusPublished - Aug 2023

Bibliographical note

JEL Classifcation I18 · H41

Funding Information:
The data collection was funded by the European Commission under the Horizon 2020 research and innovation programme (Grant agreement No. 643476) and part of the COMPARE project ( http://www.compare-europe.eu/ ). S.F.W. Himmler receives funding from a Marie Sklodowska-Curie fellowship financed by the European Commission (Grant agreement No. 721402).

Publisher Copyright: © 2022, The Author(s).


Dive into the research topics of 'Willingness to pay for health gains from an international integrated early warning system for infectious disease outbreaks'. Together they form a unique fingerprint.

Cite this