What needs to be done in contingent valuation: have Smith and Sach missed the boat?

It is possible to stretch analogies too far, which is how some readers may interpret this response to Smith and Sach’s latest journey on the good ship ‘willingness-to-pay-database’. They can be dangerous tools to use too, if only because it is difficult to resist the inclination to respond in kind! In their paper, ‘Contingent valuation: what needs to be done?’, Smith and Sach seek to show that contingent valuation (CV) research in health is like a ship without a sail. The solution they arrive at is to suggest ‘more guidelines needed’, although it is not clear if they mean guidelines for reporting of studies or guidelines for the conduct of studies. Generally, our assessment of the paper is that the authors seem to have set sail without a compass, thus taking a rather roundabout route to arrive at what are not only barren but also dangerous shores. Furthermore, it is surprising that they even got that far, as they seem to have set off without a destination in mind. Their paper assesses the state of the art in CV in health by presenting frequencies of published articles exhibiting certain predetermined attributes. Had they focussed, instead, on a more in-depth account of the literature they cite, as well as on significant chunks of literature in the health (and other) area(s) of application currently missing from their analysis, a different assessment of the developments in CV in health would have been portrayed and the perils of arriving on the shores of guideline-land avoided.