This study examined whether people are willing to pay for health apps, how much they would pay, and why some people refuse to pay. Among 577 survey respondents, 58.9% said they were willing to pay, with a median willingness to pay of HK$50. People with a bachelor's degree or higher and people who had previously installed health apps were more likely to be willing to pay. The main reasons for not paying were the belief that governments should provide free apps, distrust of health apps, and low awareness of their benefits.

1. Introduction: Why Health Apps Matter

Health apps are increasingly used for health knowledge exchange, chronic disease management, mental health care, physical activity, and other healthcare activities. They can support healthier behavior and broaden access to care across different backgrounds and living conditions.

The benefits of health apps depend on whether users buy them and continue using them. That makes willingness to pay (WTP) important for developers, policymakers, and researchers. Developers can use this insight to evaluate return on investment, pricing, and product-market fit, while policymakers can use it to improve affordability and access.

Earlier research has explored adoption, preferences, facilitators, and barriers, but less is known about how much people are willing to pay and why. This study set out to fill that gap.

2. Methods: Survey-Based Data Collection and Analysis

The study used a cross-sectional survey. It collected demographic information, prior health app installation and spending, willingness to pay, and reasons for being unwilling to pay.

WTP was measured with an open-ended question: "What is the maximum amount you would pay for a health app?" Respondents who answered HK$0 were asked why they were unwilling to pay.

The survey defined health apps as smartphone software that helps with health management, such as tracking health indicators, supporting healthy behaviors, teaching exercise or diet practices, providing disease prevention information, or sending reminders.

Researchers invited 600 adults to participate and used quota sampling to reflect age, gender, and residential district. The final sample included 577 completed responses. Data were analyzed with descriptive statistics, logistic regression for willingness to pay, and log-linear regression for WTP amount among willing respondents.

3. Results: Willingness to Pay and Its Context

3.1. Participant Characteristics

After excluding 23 incomplete questionnaires, 577 responses were analyzed. Participants had a mean age of 46.2 years, and 47.0% had previously installed at least one health app. The most common categories were healthy living information apps, vitality measurement apps, and health or medical reminder apps.

Only 9.9% had previously paid for a health app. Among those who had paid, both the mode and median highest payment were HK$100.

3.2. Willingness to Pay

Overall, 58.9% of participants were willing to pay for a health app. The median WTP was HK$50, with a mode of HK$100 and a mean of HK$170.41. The results suggest there is meaningful market potential and a price range that consumers may accept.

3.3. Sociodemographic Correlates of Being Willing to Pay

Two factors were significantly associated with willingness to pay.

• Participants with a bachelor's degree or higher were 2.59 times more likely to be willing to pay.
• Participants who had previously installed a health app were 1.90 times more likely to be willing to pay.

Gender, age, monthly household income, and previous highest payment were not significantly associated with whether someone was willing to pay.

3.4. Correlates of WTP Amount

Among participants who were willing to pay, the strongest significant factor was the highest amount they had previously paid for a health app. People who had paid more in the past tended to report a higher WTP for future health apps.

3.5. Reasons for Being Unwilling to Pay

Among participants unwilling to pay, the most common reasons were:

• The government should provide free health apps.
• They did not trust health apps.
• They did not know what health apps were.
• They did not think health apps would benefit them.

Other reasons included lack of a suitable app, not knowing how to use apps, lack of time, and inability to afford the cost.

4. Discussion: Implications of the Findings

4.1. Installation and Payment Experience

Nearly half of participants had installed a health app before, suggesting that health app use has grown with smartphone access and capability. Broader adoption may require public communication through channels such as social media, as well as integration with healthcare institutions and public health infrastructure.

At the same time, relatively few participants had paid for apps. Developers can reduce this barrier by offering free versions, trial experiences, tiered pricing, subscriptions, or subsidies for financially vulnerable groups.

4.2. Implications for Willingness to Pay

The finding that many participants were willing to pay, with a median WTP of HK$50, points to a real but price-sensitive market. Developers and marketers can use this range to design pricing strategies that match consumer expectations, especially for high-quality, evidence-based, user-friendly apps.

4.3. Sociodemographic Findings

4.3.1. Education

People with a bachelor's degree or higher were more likely to pay, possibly because they are more comfortable with health technologies or have stronger health literacy. This also suggests that some apps may be too complex for users with lower education or health literacy. Developers should prioritize intuitive design, concise instructions, and accessible interfaces.

4.3.2. Prior App Installation

People who had previously installed health apps were more likely to pay, likely because they had experienced perceived benefits. This supports offering free "lite" versions so users can try an app before deciding whether to pay.

4.4. Previous Payment Amount

Participants who had previously paid more for health apps also reported higher WTP. This may reflect stronger health priorities, positive prior experiences, or higher expectations. The result highlights the importance of continuous innovation, useful features, and sustained value.

4.5. Why Some People Refuse to Pay

4.5.1. Expectation of Free Government Apps

The belief that governments should provide free health apps reflects trust in government-backed health technology and suggests that public authorities may play an important role in expanding access.

4.5.2. Distrust of Health Apps

Distrust can relate to reliability, effectiveness, usability, security, or personal data use. Developers can respond by working with medical professionals, improving usability testing, providing transparent data controls, and implementing strong security measures. Regulators can also create quality standards and oversight mechanisms.

4.5.3. Low Awareness of Health Apps and Their Benefits

Some participants were unwilling to pay because they did not understand health apps or their benefits. Education campaigns and clinician recommendations could improve awareness, although further research is needed to confirm the effectiveness of these approaches.

4.6. Limitations

The study has several limitations. WTP was self-reported and hypothetical, the questionnaire was not formally validated, participants recruited in public places may have introduced selection bias, and the study did not examine how different app types or WTP measurement methods might affect responses.

Conclusion

The study answers important questions about whether people will pay for health apps, how much they may pay, and why some refuse. It shows clear growth potential for the health app market and points to practical improvements in quality, usability, trust, pricing, and policy oversight.