Is the Willingness to Pay for Years of Life in an Extreme Situation of the COVID Pandemic Closures Similar to the Willingness to Pay in Situations of Ordinary Basis? Comparison By Population Groups

OBJECTIVES: To estimate the Willingness-to-Pay (WTP) of Israeli adults for one human life year (LY), in two contexts: 1) COVID pandemic closures and 2) Ordinary basis ; in order to bring people's preferences to the regulatory decisions.

METHODS: A survey among 2,200 Arabic and/or Hebrew speaking adults was performed in March 2022. Respondents were allocated randomly to one of two on-line based questionnaires: A. hypothetical scenarios of closures due to pandemic in which they were provided with 3 choice sets; each with 2 alternatives. Each alternative consisted of combinations of three attributes: lock-down severity (low/medium/high), number of LYs saved and increase in the tax income. B. Second questionnaire provided different health reforms scenarios with number of LYs saved attached to each, in which the interviewees stated preferences of their WTP.

The independent variables included: age, gender, ethnicity, education, risk perception and health state.

RESULTS: 34% among those who answered the COVID pandemic closures questionnaire, always choose the lowest alternative of WTP (Low) and 26% always choose the highest (High). The others 40% choose inconsistently between the alternatives. In a multilogistic analysis the adjusted odds of being inconsistent or Low compared to High were significantly higher for those with low education, with no kids and of an Arab origin.

Among those who answered the ordinary basis questionnaire, more than 90% choose inconsistently between the alternatives, however women and Arabs tend to state lower prices.

The Median WTP for saving one LY among those who answered the ordinary basis scenarios (47,900€) was lower than in the pandemic scenarios (58,900€).

CONCLUSIONS: In general, people tend to be more consistent and willing to pay higher prices in extreme situations, in addition minority groups and those with a lower education state different preferences than the majority.