Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment

BackgroundThe adoption of high-quality health apps has been slow, despite the myriad benefits associated with their use. This is partly due to concerns regarding the effectiveness, safety, and data privacy of such apps. Quality assessments with robust and transparent criteria...

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Main Authors: Anna-Lena Frey, Simon Leigh, Carla Toro, Carme Pratdepàdua Bufill, Charles McCay, Tatjana Prenđa Trupec, Giuseppe D'Avenio, Menno Kok, Antanas Montvila, Philipp Goedecker, Petra Hoogendoorn
Format: Article
Language:English
Published: JMIR Publications 2025-05-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2025/1/e57474
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author Anna-Lena Frey
Simon Leigh
Carla Toro
Carme Pratdepàdua Bufill
Charles McCay
Tatjana Prenđa Trupec
Giuseppe D'Avenio
Menno Kok
Antanas Montvila
Philipp Goedecker
Petra Hoogendoorn
author_facet Anna-Lena Frey
Simon Leigh
Carla Toro
Carme Pratdepàdua Bufill
Charles McCay
Tatjana Prenđa Trupec
Giuseppe D'Avenio
Menno Kok
Antanas Montvila
Philipp Goedecker
Petra Hoogendoorn
author_sort Anna-Lena Frey
collection DOAJ
description BackgroundThe adoption of high-quality health apps has been slow, despite the myriad benefits associated with their use. This is partly due to concerns regarding the effectiveness, safety, and data privacy of such apps. Quality assessments with robust and transparent criteria can address these concerns and, thereby, encourage the use of high-quality apps. However, a major challenge for such assessments is reaching a scale at which a substantial proportion of the more than 350,000 available health apps can be evaluated. ObjectiveTo support the scaling of health app quality assessments, this study aimed to examine the preferences and willingness to pay for assessments with different value propositions among potential customers. MethodsWe conducted 2 discrete choice experiments: one with 41 health app developers and another with 46 health system representatives (from health care institutions, authorities, and insurers) from across Europe. Mixed logit models were applied to examine the impact of assessment attributes on participants’ choices as well as to calculate marginal willingness to pay and predicted assessment uptake. ResultsAmong health app developers, the attributes with the largest impact on assessment choices were the associated clinical care uptake (integration into clinical guidelines and reimbursement or procurement) and cost (purchase price). Increased willingness to use assessed apps and app store integration of assessment results had a moderate impact on choices, while required developer time investment and time until assessment results become available made the smallest contribution. Among health system representatives, increased willingness of clinicians and patients to use evaluated apps had the greatest impact on assessment choices, followed by cost. Time until assessment result availability and the percentage of peers recommending the assessment made a moderate contribution, while reassessment frequency had the smallest impact on choices. On average, health app developers were willing to pay an additional €9020 (95% CI €4968-€13,072) if an assessment facilitates guideline integration and procurement or reimbursement (at the time of data collection, €1=US $1.11), while health system representatives were, on average, willing to pay €7037 (95% CI €4267-€9806) more if an assessment results in a large, rather than a small, increase in willingness to use the evaluated app. The predicted uptake of assessments that offer the preferred values for all attributes was 88.6% among app developers and 91.1% among health system representatives. ConclusionsThese findings indicate that, to maximize uptake and willingness to pay among health app developers, it is advisable for assessments to facilitate or enable clinical guideline integration and reimbursement or procurement for high-scoring apps. Assessment scaling thus requires close collaboration with health authorities, health care institutions, and insurers. Furthermore, if health system organizations are targeted as customers, it is essential to provide evidence for the assessment’s impact on patients’ and clinicians’ willingness to use health apps.
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spelling doaj-art-9002695c1f9a413f9d503f19b4e88edf2025-08-20T03:48:28ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222025-05-0113e5747410.2196/57474Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice ExperimentAnna-Lena Freyhttps://orcid.org/0000-0003-1653-3023Simon Leighhttps://orcid.org/0000-0002-6843-6447Carla Torohttps://orcid.org/0000-0001-6351-1340Carme Pratdepàdua Bufillhttps://orcid.org/0000-0002-2540-7638Charles McCayhttps://orcid.org/0000-0002-4462-5948Tatjana Prenđa Trupechttps://orcid.org/0000-0003-1122-5443Giuseppe D'Aveniohttps://orcid.org/0000-0002-9717-2487Menno Kokhttps://orcid.org/0009-0005-3116-6892Antanas Montvilahttps://orcid.org/0000-0001-8657-8476Philipp Goedeckerhttps://orcid.org/0009-0002-5678-8135Petra Hoogendoornhttps://orcid.org/0000-0003-3824-648X BackgroundThe adoption of high-quality health apps has been slow, despite the myriad benefits associated with their use. This is partly due to concerns regarding the effectiveness, safety, and data privacy of such apps. Quality assessments with robust and transparent criteria can address these concerns and, thereby, encourage the use of high-quality apps. However, a major challenge for such assessments is reaching a scale at which a substantial proportion of the more than 350,000 available health apps can be evaluated. ObjectiveTo support the scaling of health app quality assessments, this study aimed to examine the preferences and willingness to pay for assessments with different value propositions among potential customers. MethodsWe conducted 2 discrete choice experiments: one with 41 health app developers and another with 46 health system representatives (from health care institutions, authorities, and insurers) from across Europe. Mixed logit models were applied to examine the impact of assessment attributes on participants’ choices as well as to calculate marginal willingness to pay and predicted assessment uptake. ResultsAmong health app developers, the attributes with the largest impact on assessment choices were the associated clinical care uptake (integration into clinical guidelines and reimbursement or procurement) and cost (purchase price). Increased willingness to use assessed apps and app store integration of assessment results had a moderate impact on choices, while required developer time investment and time until assessment results become available made the smallest contribution. Among health system representatives, increased willingness of clinicians and patients to use evaluated apps had the greatest impact on assessment choices, followed by cost. Time until assessment result availability and the percentage of peers recommending the assessment made a moderate contribution, while reassessment frequency had the smallest impact on choices. On average, health app developers were willing to pay an additional €9020 (95% CI €4968-€13,072) if an assessment facilitates guideline integration and procurement or reimbursement (at the time of data collection, €1=US $1.11), while health system representatives were, on average, willing to pay €7037 (95% CI €4267-€9806) more if an assessment results in a large, rather than a small, increase in willingness to use the evaluated app. The predicted uptake of assessments that offer the preferred values for all attributes was 88.6% among app developers and 91.1% among health system representatives. ConclusionsThese findings indicate that, to maximize uptake and willingness to pay among health app developers, it is advisable for assessments to facilitate or enable clinical guideline integration and reimbursement or procurement for high-scoring apps. Assessment scaling thus requires close collaboration with health authorities, health care institutions, and insurers. Furthermore, if health system organizations are targeted as customers, it is essential to provide evidence for the assessment’s impact on patients’ and clinicians’ willingness to use health apps.https://mhealth.jmir.org/2025/1/e57474
spellingShingle Anna-Lena Frey
Simon Leigh
Carla Toro
Carme Pratdepàdua Bufill
Charles McCay
Tatjana Prenđa Trupec
Giuseppe D'Avenio
Menno Kok
Antanas Montvila
Philipp Goedecker
Petra Hoogendoorn
Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
JMIR mHealth and uHealth
title Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
title_full Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
title_fullStr Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
title_full_unstemmed Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
title_short Preferences and Willingness to Pay for Health App Assessments Among Health Care Stakeholders: Discrete Choice Experiment
title_sort preferences and willingness to pay for health app assessments among health care stakeholders discrete choice experiment
url https://mhealth.jmir.org/2025/1/e57474
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