This study sought to understand whether people are willing to pay for health apps, how much they would pay, and why some are unwilling to pay at all. Analysis of 577 survey responses found that approximately 58.9% of respondents were willing to pay for health apps, with a median willingness-to-pay (WTP) of HK$50. Those with a bachelor's degree or higher, and those who had previously installed a health app, showed greater willingness to pay, and WTP was also associated with the highest amount previously paid for a health app. The main reasons for being unwilling to pay were the belief that the government should provide free apps, distrust of health apps, and lack of awareness about health apps and their benefits. These findings reveal the potential of the health app market and can help improve the marketability, accessibility, and pricing strategies of health apps. 😊

1. Introduction: The Importance of Health Apps and the Need for This Research

Health apps are increasingly being used across a wide range of healthcare activities — including health knowledge exchange, chronic disease management, mental health support, and physical activity promotion. These apps have the potential to improve health outcomes and provide equitable access to healthcare for people from diverse backgrounds and living environments. Some countries, such as Germany and the UK, have already launched public health initiatives — including digital health app programs, the NHS ORCHA app library, and NHSX — to encourage the use of health apps. 📱

The benefits of health apps depend on whether users are willing to actively purchase and consistently use them. It is therefore critically important to understand whether people are willing to pay for health apps, how much they are willing to pay (WTP), and why they hold those views. This understanding can help health app developers assess return on investment, improve pricing strategies and resource allocation, develop more marketable apps, and enhance business sustainability. For policymakers and researchers, it plays a key role in developing strategies to improve access to health apps and establish reasonable pricing policies, so that more people can benefit from them.

Existing research has explored the prevalence, adoption, preferences, and facilitators and barriers to health app use — but understanding of how much, why, and under what conditions people are willing to pay for health apps has remained limited. This gap in knowledge can hinder the commercial success of health apps and constrain the spread of their benefits. This study aimed to bridge that gap.

2. Methods: Data Collection and Analysis via Survey

The study was conducted using a cross-sectional survey design. Participants' sociodemographic characteristics (age, sex, household size, monthly household income, education level), prior health app installation history and the highest amount previously paid, and their WTP for health apps and reasons for being unwilling to pay were all assessed.

WTP for health apps was measured using an open-ended question: "What is the maximum amount you would pay for a health app?" This approach was chosen to allow respondents to answer candidly without being anchored to a specific amount. Respondents who indicated a WTP of HK$0 were classified as "unwilling to pay for health apps" and were asked to select specific reasons for their unwillingness. In addition to a set of predefined options, respondents could also write in their own reasons. 📝

Definition of health app: A clear definition was provided to all participants to ensure a consistent understanding:

"A health app is a software program installed on a smartphone to help manage health. Some health apps can help track health status by recording health statistics (e.g., weight, blood pressure, blood glucose, physical activity level, sleep quality, diet). Some health apps can benefit users by providing information that promotes healthy behaviors. A health app may teach users how to perform specific physical exercises or maintain a healthy diet, or provide information about disease prevention and management. Health apps may also send reminders to follow these health behaviors."

A total of 600 adults were invited to participate. Quota sampling was used to ensure representation across diverse demographics including age, sex, and residential district. Although a minimum of 385 participants was required, the target was set at 600 to maximize representativeness and generalizability within the available budget. Surveys were administered in high-traffic public locations accessible to a diverse population, including shopping malls, MTR stations, residential areas, and parks. All participants provided written informed consent, and the study was approved by the Human Research Ethics Committee of The University of Hong Kong. Participants received a HK$50 supermarket voucher upon completing the survey. 💰

Data analysis used descriptive statistics to summarize participant characteristics and WTP, and logistic regression to identify associations between willingness to pay and sociodemographic variables. For participants who were willing to pay, log-linear regression was used to examine the association between WTP amount and sociodemographic variables. Reasons for being unwilling to pay were analyzed descriptively. All statistical analyses were performed using IBM SPSS Statistics, with a significance level of p < 0.05.

3. Results: Willingness to Pay for Health Apps and Associated Factors

3.1. Participant Characteristics

Of 600 participants, 23 did not complete the questionnaire and were excluded from the analysis. The final analysis therefore included data from 577 participants. There were no significant differences in sex, age group, or residential district between those who did and did not complete the survey.

The mean age of participants was 46.2 years (SD 15.8; range: 18–82). Nearly half of all participants — 47.0% (271/577) — had previously installed at least one health app. The most commonly installed types were healthy lifestyle information apps (34.8%), vital signs recording apps (19.1%), and health and medical reminder apps (8.7%). 📊

Only 9.9% (57/577) of participants had previously paid for a health app. Among these, the mode of the highest amount previously paid was HK$100, the median was HK$100, and the mean was HK$268.40.

3.2. Willingness to Pay (WTP) for Health Apps

Overall, 58.9% (340/577) of participants indicated they were willing to pay for health apps. 🥳 The mode of WTP was HK$100, and the median WTP was HK$50 (Q1: HK$20; Q3: HK$100). The mean was HK$170.41. These findings suggest that there is substantial opportunity in the health app market and that a price range acceptable to consumers does exist.

3.3. Sociodemographic Correlates of Willingness to Pay

Analysis of sociodemographic factors associated with willingness to pay for health apps identified two statistically significant predictors:

• Bachelor's degree or higher: Participants with at least a bachelor's degree were 2.59 times more likely to be willing to pay for health apps (p = 0.01). 🎓
• Prior health app installation experience: Participants who had previously installed a health app were 1.90 times more likely to be willing to pay for health apps (p < 0.01).

Other factors — including sex, age, monthly household income, and the highest amount previously paid — were not significantly associated with willingness to pay.

3.4. Sociodemographic Correlates of WTP Amount

Among participants who were willing to pay, the sociodemographic factors associated with the WTP amount were examined. Results showed a significant positive association between the highest amount previously paid for a health app and WTP (coefficient = 0.002, p < 0.01). In other words, those who had paid more for a health app in the past were willing to pay more for health apps in general. 💸

Sex, age, monthly household income, education level, and prior health app installation experience were not significantly associated with WTP amount.

3.5. Reasons for Being Unwilling to Pay

Among participants who were unwilling to pay for health apps (41.1%, 237/577), the most commonly cited reasons were as follows:

• "The government should provide free health apps" (12.0%, 69/577): the most frequently mentioned reason.
• "I do not trust health apps" (10.2%, 59/577): distrust was another important barrier.
• "I do not know what health apps are" (9.9%, 57/577): lack of awareness was also prevalent.
• "Health apps offer me no benefit" (9.5%, 55/577): some respondents did not perceive value in health apps.

Additional reasons mentioned included not finding an app suited to their needs, not knowing how to use apps, not having time to use apps, and not being able to afford app costs.

4. Discussion: Implications of the Findings

4.1. Reflections on Health App Installation and Payment Experience

Nearly half of all participants had previously installed a health app. This reflects an increase in health app use compared to earlier periods, likely driven by advances in smartphone capabilities and improved accessibility. To further promote health app adoption, it is important to leverage mass media channels such as social media to explain the features and benefits of health apps and encourage their use. Authorities should also encourage healthcare organizations to integrate health apps into existing public health infrastructure, thereby improving access to and convenience of healthcare services.

However, while many people have shown interest in installing health apps, relatively few had previously paid for a health app. This may reflect uncertainty about the benefits of paid apps or financial constraints. To overcome these barriers, health app developers are advised to offer free versions of their apps so users can evaluate their usefulness before purchasing. A "try before you buy" approach can increase users' familiarity with the technology and boost satisfaction, ultimately encouraging purchases of paid apps. 💸

Developers can also implement flexible pricing options such as tiered pricing or subscription models to address financial constraints and broaden access across different population groups. This can accommodate users with varying budgets and promote wider adoption. Furthermore, providing purchase incentives or subsidies for economically disadvantaged populations would help improve equitable access to digital health tools.

4.2. Implications for Willingness to Pay (WTP)

The finding that a substantial proportion of participants were willing to pay for health apps — with a median WTP of HK$50 — indicates both the considerable potential of the health app market and the existence of a price range that consumers find acceptable. Developers and marketers can use these insights to formulate pricing strategies aligned with potential users' expectations. The market demand observed in this study underscores the growing need for high-quality, evidence-based, and user-friendly health apps. ✨

4.3. Sociodemographic Correlates of Willingness to Pay

4.3.1. The Role of Education Level

The finding that individuals with a bachelor's degree or higher were more willing to pay for health apps is an important one. This may reflect the greater likelihood that more highly educated individuals will adopt and use health technologies such as health apps. It may also reflect higher health literacy among this group, enabling them to better understand and leverage the benefits of health apps.

These findings suggest that some health apps may be too complex for individuals with lower education levels or limited health literacy. Developers should therefore prioritize intuitive design, clear instructions, and optimized user interfaces to make health apps more accessible and user-friendly. 👶

4.3.2. The Role of Prior Health App Installation Experience

The greater willingness to pay among participants who had previously installed a health app is likely attributable to the perceived benefits they gained from those earlier apps. This experience may lead to the expectation that other health apps will offer similar benefits, thereby increasing their willingness to pay for additional apps.

These findings support the argument that health app developers should offer free "lite" versions of their apps so users can try them first. Once users have experienced genuine benefits from a health app, they are more likely to be willing to pay for similar apps in the future.

4.4. Sociodemographic Correlates of WTP Amount

4.4.1. The Role of the Highest Amount Previously Paid

The positive association between the highest amount previously paid for a health app and current WTP suggests that people with higher WTP are likely those who consistently place high value on health and view health apps as worthwhile investments. Those who previously paid for and were satisfied with a high-priced health app may have developed higher expectations for other health apps, thereby increasing their WTP.

These findings highlight the importance of continuous innovation and the introduction of new features and services in the health app industry to meet consumer expectations. Doing so can sustain the interest and satisfaction of existing users and ensure long-term viability. Such ongoing development efforts can help health apps remain relevant, effective, and valuable in a competitive digital marketplace. 💪

4.5. Reasons for Being Unwilling to Pay

4.5.1. Expectation That the Government Should Provide Free Health Apps

The most commonly cited reason — "the government should provide free health apps" — reflects a high degree of trust in government-endorsed health apps and highlights the important role of government in promoting health technology. In some countries, such as Germany, third-party bodies have already begun integrating health apps into reimbursement systems as these apps have demonstrated their potential to provide effective public health services. Government provision of free health apps to the public can improve access to health information and services, enhance public health, reduce the burden on healthcare systems, and increase the efficiency of healthcare resource allocation. 🌐

4.5.2. Distrust of Health Apps

Distrust also emerged as a significant barrier to WTP. This distrust may relate to concerns about the reliability, effectiveness, and security of health apps. To address this, health app developers should work with healthcare professionals to ensure the clinical relevance and accuracy of their apps. Regulatory bodies could establish credible oversight mechanisms to verify that health apps meet specific quality standards before reaching the market.

Poor usability in health apps can lead to user errors and ultimately to distrust of the technology. Developers can mitigate this by conducting usability testing to identify and resolve issues early in the development process. Concerns about the misuse of personal health information are another potential source of distrust. Developers can address user concerns and build trust by providing transparent data control options and clear guidelines, clearly informing users about how their data is collected and used, and implementing robust security measures to prevent data breaches. Policymakers should also consider regulating the collection, use, and transfer of personal information by health apps. 🔐

4.5.3. Lack of Awareness of Health Apps and Their Benefits

Lack of awareness or understanding of health apps and their potential benefits was also a major reason participants were unwilling to pay. This lack of awareness may be attributed to low health literacy and digital health literacy, which can reduce people's ability to recognize the value and advantages of health services and technologies.

To raise public awareness of health apps, educational and awareness campaigns targeting the general public can be launched to convey essential health knowledge and actively promote health app use. Healthcare professionals could also be encouraged to prescribe health apps to patients as a supplement to self-management. However, additional research is needed to demonstrate the effectiveness of such approaches and to encourage engagement from the healthcare community. 👨‍⚕️👩‍⚕️

4.6. Limitations

This study has several limitations. First, health app WTP was based on participants' self-reported hypothetical willingness to pay, which may not accurately reflect actual payment behavior in real-world situations. Second, the questionnaire used was not formally validated, which may have affected the results. Third, participants recruited in public places were sufficiently healthy to be outdoors, which may have introduced selection bias. Fourth, the study did not explore the effects of health app type diversity or differences in WTP measurement approaches on the results. Future research should address these limitations to provide more accurate and comprehensive insights.

Conclusion

This study sought to answer important questions about whether people are willing to pay for health apps, how much they are willing to pay, and why some are not willing to pay at all. The findings clearly demonstrate the growth potential of the health app market and offer several implications for improving health app adoption and use.

Developers should focus on enhancing the quality, usability, and value proposition of health apps to earn user trust and attract potential customers. At the same time, policymakers and regulatory bodies must take responsibility for ensuring transparency and quality assurance in the health app market. When these efforts are pursued together, health apps can successfully establish themselves in the market and contribute meaningfully to the health and well-being of a broader population. 🌈