The European Journal of Health Economics

, Volume 13, Issue 3, pp 289–300 | Cite as

Cancer patients’ willingness to pay for blood transfusions at home: results from a contingent valuation study in a French cancer network

  • Nathalie Havet
  • Magali Morelle
  • Raphaël Remonnay
  • Marie-Odile Carrere
Original Paper


Home blood transfusion may be an interesting alternative to hospital transfusion, especially when given with curative or palliative intent or for terminal care in advanced-stage cancer patients. However, there is limited information about patients’ attitude toward this type of care. The purpose of this study was to measure French cancer patients’ willingness to pay (WTP) for home blood transfusion and to analyze determinants of their choice. A contingent valuation survey was administered to 139 patients receiving transfusions in the framework of a regional home care network or in the hospital outpatient department. Participation was high (90%). Most patients (65%) had received home care, including 43% blood transfusions. Just under half of the patients gave a zero WTP, among which we identified 8 protest bidders. The median WTP for home blood transfusion was 26.5 € per patient. In multivariate analysis, long home–hospital distance, poor quality of life, and previous experience of home care were identified as important factors in determining how much more patients would be willing to pay for transfusion at home. These results demonstrate the benefits of developing domiciliary services to improve patient well-being, notably for the weakest among them. The significant impact of previous home care experience on WTP is probably related to the strong involvement of physicians from the blood center and to their active contribution to a high-level homecare network. Some of our findings could be useful for policy decision-making regarding home care.


Contingent valuation Blood transfusion Home care services Oncology 

JEL Classification

I1 (health) I3 (welfare) C5 (econometric modeling) H41 (public good) 



The authors would like to thank the French Ministry of Health (PHRC) for the financial support of this research. They thank also Dr Yves Devaux, Josette Chalencon, and Valerie Kante for their contribution to patient recruitment, Matthias Candusso for data collection, and Marie-Dominique Reynaud for editorial assistance.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Nathalie Havet
    • 1
  • Magali Morelle
    • 2
  • Raphaël Remonnay
    • 2
  • Marie-Odile Carrere
    • 2
  1. 1.GATE Lyon-Saint EtienneUniversity of LyonEcullyFrance
  2. 2.GATE Lyon-Saint EtienneUniversity of Lyon, Léon Bérard Comprehensive Cancer CenterLyon Cedex 08France

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