Preference between Prevention versus Treatment of Cancer

MD. Azharuddin Akhtar∗ 1

and Indrani Roy Chowdhury† 2

1
Associate Research Fellow, Institute of Human Development
2
Professor, CSRD, Jawaharlal Nehru University

March 2024

Abstract

Introduction: In the realm of health economics, empirical research often assesses the trade-
offs between prevention and treatment strategies, particularly focusing on cases involving minor
health issues or different public health interventions. However, scant attention has been given
to exploring individual preferences when facing the looming threat of life-threatening diseases
such as cancer, which profoundly impacts perceptions and instils deep-seated fears regarding
health and associated costs. This study addresses this gap by examining the preferences be-
tween prevention and treatment options and corresponding valuation for reduced/eliminated
cancer mortality risk among individuals exposed to risk factors.

Data Source: Primary data for this study were gathered through a cross-sectional household
survey conducted in the Indian state of West Bengal from 2019 to 2021, aiming for regional rep-
resentatives across four districts: North 24 Parganas, South 24 Parganas, Kolkata, and Bankura.

Method: Utilizing the Contingent Valuation Method (CVM) framework within a hypothetical
scenario, this study evaluates preferences and valuation (Willingness to Pay, WTP) for reducing
or eliminating cancer mortality risk under both prevention and treatment interventions. Distinc-
tions are made between ”statistical life” associated with prevention and ”identified life” linked
to treatment. By focusing on cancer mortality risk instead of incidence, the study minimizes
the potential confounding effects of baseline risk. Initial assessments encompassed respondents’
awareness of cancer, knowledge of preventive and treatment interventions, self-perceived cancer
risk, beliefs regarding intervention effectiveness, and anticipated costs. Subsequently, respon-
dents were educated comprehensively about the disease and presented with a hypothetical choice
scenario between prevention and treatment, followed by elicitation of their WTP for their pre-
ferred intervention.

Preliminary Result: Higher levels of education, greater per-capita income, and medical insur-
ance coverage were associated with a higher likelihood of preferring prevention over treatment.
∗ Email: azharuddin.akhtar@gmail.com
† Email: iroychowdhury@mail.jnu.ac.in

1
This preference aligns with the understanding that cancer poses a significant threat with consid-
erable economic burdens. Socioeconomically disadvantaged groups may face higher opportunity
costs in avoiding cancer risks, leading to a preference for treatment despite the associated mor-
bidity risks. Notably, respondents in better health exhibited lower risk aversion and were less
inclined towards prevention. While self-perceived cancer risk did not significantly impact pref-
erence, socioeconomic factors such as education, income, and insurance coverage emerged as
significant determinants of WTP. Respondents opting for prevention demonstrated a WTP be-
tween Rs 900 to Rs 1,274 per year, while those preferring treatment were willing to pay between
Rs 1000 to Rs 2,000 per month.

Conclusion: This study underscores the importance of resources allocation between prevention
and treatment in public health policy. While a trade-off exists between preventing adverse health
outcomes and treating existing conditions, policymakers must consider individuals’ preferences
and the marginal rate of substitution for health improvements. Low awareness of disease risks
impedes individuals’ ability to make informed choices, highlighting the need for targeted health
education efforts. Ultimately, policies should not solely prioritize treatment but also emphasize
prevention, tailored to individual preferences and socioeconomic realities.

Key words: Prevention, Treatment, Cancer, Contingent Valuation Method, Willingness to Pay