Willingness-To-Pay for COVID-19 Vaccine in Low and Middle-Income Countries Compared to High-Income Countries: A Systematic Review

Aims: By focusing largely on lower-income countries, this study adds to the evolving worldwide picture of willingness to pay for COVID19 vaccination. Willingness-To-Pay (WTP) values for the pandemic COVID-19 vaccine, which provide monetary indicators of community preferences for vaccines, could help policymakers in low- and middle-income countries determine priorities for health resource utilization. Study Design: Systematic Review. Methodology: A systematic review of the study on willingness to pay for COVID-19 vaccine in the Pubmed, Science Direct, and Scopus through January 2022 was performed to find relevant articles published between January 2020 and January 2022. Following PRISMA guidelines, the study yielded 19 English-language studies (12 studies in low- and middle-income countries, 2 in high-income countries, and 5 in upper-middle-income countries) that evaluated WTP for COVID-19 vaccines, either existing or hypothetical vaccines. All WTP values extracted were converted to 2021 United States Dollars (USD) for comparability Results: This study showed that the willingness to pay in low-middle-income countries varied from USD 1.2 to USD 85.92. Studies conducted in the same country might have different WTP values. Average WTP in low-income countries have lower WTPs than high and upper-middle-income countries. In addition to being in line with differences in GDP, cases and deaths from COVID-19 in high-income countries are higher than in low-income countries. Conclusion: From low-middle income countries evaluation, the high value of WTP is not consistently aligned with the high value of GDP per capita from each country. The finding demonstrates that the factors that affect the value of WTP are not only the GDP per capita of the country. The perception of risk, the WTP evaluation method used, and several other factors that need to be studied further also affect the amount of WTP.