1
|
De Guzman KR, Smith AC, Snoswell CL. General practitioner preferences for telehealth consultations in Australia: a pilot survey and discrete choice experiment. Prim Health Care Res Dev 2024; 25:e28. [PMID: 38721700 DOI: 10.1017/s1463423624000136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
AIM To identify and quantify general practitioner (GP) preferences related to service attributes of clinical consultations, including telehealth consultations, in Australia. BACKGROUND GPs have been increasingly using telehealth to deliver patient care since the onset of the 2019 coronavirus disease (COVID-19) pandemic. GP preferences for telehealth service models will play an important role in the uptake and sustainability of telehealth services post-pandemic. METHODS An online survey was used to ask GPs general telehealth questions and have them complete a discrete choice experiment (DCE). The DCE elicited GP preferences for various service attributes of telehealth (telephone and videoconference) consultations. The DCE investigated five service attributes, including consultation mode, consultation purpose, consultation length, quality of care and rapport, and patient co-payment. Participants were presented with eight choice sets, each containing three options to choose from. Descriptive statistics was used, and mixed logit models were used to estimate and analyse the DCE data. FINDINGS A total of 60 GPs fully completed the survey. Previous telehealth experiences impacted direct preferences towards telehealth consultations across clinical presentations, although in-person modes were generally favoured (in approximately 70% of all scenarios). The DCE results lacked statistical significance which demonstrated undiscernible differences between GP preferences for some service attributes. However, it was found that GPs prefer to provide a consultation with good quality care and rapport (P < 002). GPs would also prefer to provide care to their patients rather than decline a consultation due to consultation mode, length or purpose (P < 0.0001). Based on the findings, GPs value the ability to provide high-quality care and develop rapport during a clinical consultation. This highlights the importance of recognising value-based care for future policy reforms, to ensure continued adoption and sustainability of GP telehealth services in Australia.
Collapse
Affiliation(s)
- Keshia R De Guzman
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- School of Pharmacy, The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
| | - Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| |
Collapse
|
2
|
Stadhouders N, van Vliet E, Brabers AEM, van Dijk W, Onstwedder S. Should Commercial Diagnostic Testing Be Stimulated or Discouraged? Analyzing Willingness-to-Pay and Market Externalities of Three Commercial Diagnostic Tests in The Netherlands. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:193-207. [PMID: 38099980 PMCID: PMC10864515 DOI: 10.1007/s40258-023-00846-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Consumers may purchase commercial diagnostic tests (CDT) without prior doctor consultation. This paper analyzes three CDT markets-commercial cholesterol tests (CCT), direct-to-consumer genetic health tests (DGT) and total body scans (TBS)-in the context of the universal, collectively financed health care system of the Netherlands. METHODS An online willingness-to-pay (WTP) questionnaire was sent to a representative sample of 1500 Dutch consumers. Using contingent valuation (CV) methodology, an array of bids for three self-tests were presented to the respondents. The results were extrapolated to the Dutch population and compared to current prices and follow-up medical utilization, allowing analysis from a societal perspective. RESULTS Overall, 880 of 1500 respondents completed the questionnaire (response rate 59%). Of the respondents, 26-44% were willing to pay a positive amount for the CDT. Willingness-to-pay was correlated to age and household income, but not to health status or prior experience with these tests. At mean current prices of €29 for CCT, €229 for DGT and €1,650 for TBS, 3.3%, 2.5%, and 1.1%, were willing to purchase a CCT, DGT, and TBS, respectively. All three CDT resulted in net costs to the health system, estimated at €5, €16, and €44 per test, respectively. Reducing volumes by 90,000 CCTs (19%), 19,000 DGTs (5%) and 4,000 TBSs (2.5%) in 2019 would optimize welfare. CONCLUSION Most respondents were unwilling to consume CDT at any price or only if the CDT were provided for free. However, for a small group of consumers, societal costs exceed private benefits. Therefore, CDT regulation could provide small welfare gains.
Collapse
Affiliation(s)
- Niek Stadhouders
- Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Ella van Vliet
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Anne E M Brabers
- Nivel, Netherlands Institute for Health Services Research, PO box 1568, 3500 BN, Utrecht, The Netherlands
| | - Wieteke van Dijk
- Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suzanne Onstwedder
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| |
Collapse
|
3
|
Ben-Aharon O, Sergienko R, Iskrov G, Greenberg D. Willingness to pay for an mRNA-based anti-cancer treatment: results from a contingent valuation study in Israel. Isr J Health Policy Res 2024; 13:9. [PMID: 38374060 PMCID: PMC10875764 DOI: 10.1186/s13584-024-00594-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND mRNA technology is currently being investigated for a range of oncology indications. We assessed the willingness to pay (WTP) of the general population in Israel for a hypothetical novel mRNA-based treatment for oncology indications. METHODS We used a contingent valuation methodology to elicit WTP using a web-based questionnaire. A sample of adult participants were presented with a hypothetical scenario in which an mRNA-based intervention increased the likelihood of a cure for various cancer types from 20% to 40% (half of the sample), or 60% (the other half of the sample). RESULTS 531 respondents completed the questionnaire. The mean, median and mode WTP for the proposed hypothetical treatment in both scenarios were ILS65,000 (± ILS114,000), ILS20,000 and ILS50,000, respectively (1USD = 3.4ILS). The WTP was skewed towards zero, and 9.6% of the respondents were not willing to pay any amount. WTP higher amounts was significantly associated with higher income (p < 0.01), self-reported good health (p < 0.05), supplementary health insurance (p < 0.05), Jews compared to other populations (p < 0.01), interest in technology (p < 0.001) and a tendency to adopt medical innovations (p < 0.001). No statistical difference between the 40% vs. the 60% potential cure scenarios was found. Logistic and OLS regressions indicated that age, religion, income, and interest in adopting medical innovations were the best predictors of respondents' WTP. CONCLUSION Despite the scientific breakthroughs in oncology treatment over the last few decades, many types of cancer are still incurable. Given the expected development of innovative mRNA-based treatments for cancer, these results should inform policymakers, the pharmaceutical industry and other stakeholders on the future coverage and reimbursement of these technologies incorporating patients' and societal views. To date, WTP considerations have not been given much weight in prioritization of drug reimbursement processes, neither in Israel nor in other countries. As a pioneer in adoption of the mRNA technology, Israel can also lead the incorporation of WTP considerations in this field.
Collapse
Affiliation(s)
- Omer Ben-Aharon
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
| | - Ruslan Sergienko
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Georgi Iskrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Dan Greenberg
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| |
Collapse
|
4
|
Ben-Aharon O, Iskrov G, Sagy I, Greenberg D. Willingness to pay for cancer prevention, screening, diagnosis, and treatment: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2023; 23:281-295. [PMID: 36635646 DOI: 10.1080/14737167.2023.2167713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Willingness to pay (WTP) studies examine the maximum amount of money an individual is willing to pay for a specified health intervention, and can be used to inform coverage and reimbursement decisions. Our objectives were to assess how people value cancer-related interventions, identify differences in the methodologies used, and review the trends in studies' publication. AREAS COVERED We extracted PubMed and EconLit articles published in 1997-2020 that reported WTP for cancer-related interventions, characterized the methodological differences and summarized each intervention's mean and median WTP values. We reviewed 1,331 abstracts and identified 103 relevant WTP studies, of which 37 (36%) focused on treatment followed by screening (26), prevention (21), diagnosis (7) and other interventions (12). The methods used to determine WTP values were primarily discrete-choice questions (n = 54, 52%), bidding games (15), payment cards (12) and open-ended questions (12). We found a wide variation in WTP reported values ranged from below $100 to over $20,000. EXPERT OPINION The WTP literature on oncology interventions has grown rapidly. There is considerable heterogeneity with respect to the type of interventions and diseases assessed, the respondents' characteristics, and the study methodologies. This points to the need to establish international guidelines for best practices in this field.
Collapse
Affiliation(s)
- Omer Ben-Aharon
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Georgi Iskrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Bulgaria
| | - Iftach Sagy
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.,Soroka Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Dan Greenberg
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| |
Collapse
|
5
|
Yong AC, Chuluunkhuu C, Chan VF, Stephan T, Congdon N, O’Neill C. A pilot cost-benefit analysis of a children’s spectacle reimbursement scheme: Evidence for Including children’s spectacles in Mongolia’s Social Health Insurance. PLoS One 2022; 17:e0273032. [PMID: 35969626 PMCID: PMC9377584 DOI: 10.1371/journal.pone.0273032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background and aim Globally, 12.8 million children have vision impairment due to uncorrected refractive error (URE). In Mongolia, one in five children needs but do not have access to spectacles. This pilot cost-benefit analysis aims to estimate the net benefits of a children’s spectacles reimbursement scheme in Mongolia. Methods A willingness-to-pay (WTP) survey using the contingent valuation method was administered to rural and urban Mongolia respondents. The survey assessed WTP in additional annual taxes for any child with refractive error to be provided government-subsidised spectacles. Net benefits were then calculated based on mean WTP (i.e. benefit) and cost of spectacles. Results The survey recruited 50 respondents (mean age 40.2 ± 9.86 years; 78.0% women; 100% response rate) from rural and urban Mongolia. Mean WTP was US$24.00 ± 5.15 (95% CI US$22.55 to 25.35). The average cost of a pair of spectacles in Mongolia is US$15.00. Subtracting the average cost of spectacles from mean WTP yielded a mean positive net benefit of US$9.00. Conclusion A spectacle reimbursement scheme is potentially a cost-effective intervention to address childhood vision impairment due to URE in Mongolia. These preliminary findings support the proposal of the inclusion of children’s spectacles into existing Social Health Insurance. A much larger random sample could be employed in future research to increase the precision and generalisability of findings.
Collapse
Affiliation(s)
- Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa
- * E-mail:
| | - Tai Stephan
- Orbis International, New York City, New York, United States of America
| | - Nathan Congdon
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Orbis International, New York City, New York, United States of America
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| |
Collapse
|
6
|
Yong ASJ, Lim YH, Cheong MWL, Hamzah E, Teoh SL. Willingness-to-pay for cancer treatment and outcome: a systematic review. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:1037-1057. [PMID: 34853930 DOI: 10.1007/s10198-021-01407-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Understanding patient preferences in cancer management is essential for shared decision-making. Patient or societal willingness-to-pay (WTP) for desired outcomes in cancer management represents their preferences and values of these outcomes. OBJECTIVE The aim of this systematic review is to critically evaluate how current literature has addressed WTP in relation to cancer treatment and achievement of outcomes. METHODS Seven databases were searched from inception until 2 March 2021 to include studies with primary data of WTP values for cancer treatments or achievement of outcomes that were elicited using stated preference methods. RESULTS Fifty-four studies were included in this review. All studies were published after year 2000 and more than 90% of the studies were conducted in high-income countries. Sample size of the studies ranged from 35 to 2040, with patient being the most studied population. There was a near even distribution between studies using contingent valuation and discrete choice experiment. Based on the included studies, the highest WTP values were for a quality-adjusted life year (QALY) ($11,498-$589,822), followed by 1-year survival ($3-$198,576), quality of life (QoL) improvement ($5531-$139,499), and pain reduction ($79-$94,662). Current empirical evidence suggested that improvement in QoL and pain reduction had comparable weights to survival in cancer management. CONCLUSION This systematic review provides a summary on stated preference studies that elicited patient preferences via WTP and summarised their respective values. Respondents in this review had comparable WTP for 1-year survival and QoL, suggesting that improvement in QoL should be emphasised together with survival in cancer management.
Collapse
Affiliation(s)
- Alene Sze Jing Yong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Yi Heng Lim
- School of Biosciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Mark Wing Loong Cheong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
| |
Collapse
|
7
|
Michaels JA. Value assessment frameworks: who is valuing the care in healthcare? JOURNAL OF MEDICAL ETHICS 2022; 48:419-426. [PMID: 33687915 DOI: 10.1136/medethics-2020-106503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/27/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Many healthcare agencies are producing evidence-based guidance and policy that may determine the availability of particular healthcare products and procedures, effectively rationing aspects of healthcare. They claim legitimacy for their decisions through reference to evidence-based scientific method and the implementation of just decision-making procedures, often citing the criteria of 'accountability for reasonableness'; publicity, relevance, challenge and revision, and regulation. Central to most decision methods are estimates of gains in quality-adjusted life-years (QALY), a measure that combines the length and quality of survival. However, all agree that the QALY alone is not a sufficient measure of all relevant aspects of potential healthcare benefits, and a number of value assessment frameworks have been suggested. I argue that the practical implementation of these procedures has the potential to lead to a distorted assessment of value. Undue weight may be ascribed to certain attributes, particularly those that favour commercial or political interests, while other attributes that are highly valued by society, particularly those related to care processes, may be omitted or undervalued. This may be compounded by a lack of transparency to relevant stakeholders, resulting in an inability for them to participate in, or challenge, the decisions. The makes it likely that costly new technologies, for which inflated prices can be justified by the current value frameworks, are displacing aspects of healthcare that are highly valued by society.
Collapse
Affiliation(s)
- Jonathan Anthony Michaels
- Health Economics and Decision Science, University of Sheffield School of Health and Related Research, Sheffield, UK
| |
Collapse
|
8
|
Pong S, Fowler RA, Mitsakakis N, Murthy S, Pernica JM, Gilfoyle E, Bowen A, Fontela P, Seto W, Science M, Hutchison JS, Jouvet P, Rishu A, Daneman N. Noninferiority Margin Size and Acceptance of Trial Results: Contingent Valuation Survey of Clinician Preferences for Noninferior Mortality. Med Decis Making 2022; 42:832-836. [PMID: 35583116 PMCID: PMC9277322 DOI: 10.1177/0272989x221099493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives We used modified contingent valuation methodology to determine how
noninferiority margin sizes influence clinicians’ willingness to accept
clinical trial results that compare mortality in critically ill
children. Methods We surveyed pediatric infectious diseases and critical care clinicians in
Canada, Australia, and New Zealand and randomized respondents to review 1 of
9 mock abstracts describing a noninferiority trial of bacteremic critically
ill children assigned to 7 or 14 d of antibiotics. Each scenario showed
higher mortality in the 7-d group but met noninferiority criterion. We
explored how noninferiority margins and baseline mortality rates influenced
respondent acceptance of results. Results There were 106 survey respondents: 65 (61%) critical care clinicians, 28
(26%) infectious diseases physicians, and 13 (12%) pharmacists. When
noninferiority margins were 5% and 10%, 73% (24/33) and 79% (27/33)
respondents would accept shorter treatment, compared with 44% (17/39) when
the margin was 20% (P = 0.003). Logistic regression
adjusted for baseline mortality showed 5% and 10% noninferiority margins
were more likely to be associated with acceptance of shorter treatment
compared with 20% margins (odds ratio [OR] 3.5, 95% confidence interval
[CI]: 1.3–9.6, P = 0.013; OR 5.1, 95% CI: 1.8–14.6,
P = 0.002). Baseline mortality was not a significant
predictor of acceptance of shorter treatment. Conclusions Clinicians are more likely to accept shorter treatment when noninferiority
margins are ≤10%. However, nearly half of respondents who reviewed abstracts
with 20% margins were still willing to accept shorter treatment. This is a
novel application of contingent valuation methodology to elicit acceptance
of research results among end users of the medical literature. Highlights
Collapse
Affiliation(s)
- Sandra Pong
- Department of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada
| | - Robert A Fowler
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto ON, Canada.,Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Nicholas Mitsakakis
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Srinivas Murthy
- Department of Pediatrics, Division of Critical Care, University of British Columbia, Vancouver, BC, Canada.,Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Jeffrey M Pernica
- Division of Infectious Diseases, McMaster University, Hamilton, ON, Canada
| | - Elaine Gilfoyle
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Asha Bowen
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia Perth Children's Hospital, Nedlands, WA, Australia.,Department of Infectious Diseases, Perth Children's Hospital, Nedlands, WA, Australia
| | - Patricia Fontela
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Winnie Seto
- Department of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Michelle Science
- Division of Infectious Diseases, Department of Paediatric Medicine, The Hospital for Children, Toronto, ON, Canada
| | - James S Hutchison
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Philippe Jouvet
- Pediatric Intensive Care Unit, Sainte-Justine Hospital University Center, Montreal, QC, Canada.,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Asgar Rishu
- Critical Care Research Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nick Daneman
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| |
Collapse
|
9
|
Are Potential Tourists Willing to Pay More for Improved Accessibility? Preliminary Evidence from the Gargano National Park. LAND 2022. [DOI: 10.3390/land11010075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Due to the recent COVID-19 pandemic, tourist destinations have been increasingly selected on the basis of health, safety and social distancing criteria. In this framework, protected natural areas represent ideal tourist destinations due to the presence of wide and open spaces, services for tourists and attention to nature. The present paper focused on accessible tourism, a subset of sustainable tourism that is increasingly gaining greater importance within the tourism sector. By applying the Contingent Valuation Method, the study investigated whether potential tourists are effectively willing to pay extra money to be granted more accessible facilities in a natural area. To this end, a logit model was estimated to determine the probability that tourists exhibit a higher WTP for accessible tourism facilities. The analysis was carried out in the Gargano National Park, Southern Italy, an area traditionally characterised by large tourist flows that have increased further during the recent pandemic. The results showed that only a limited percentage of the respondents are willing to pay a higher amount for improved accessibility. These results represent an interesting starting point to outline an adequate strategy for the tourism valorisation of the natural area.
Collapse
|
10
|
Latti P, Ramesan D, Ramanarayanan S. Parental perceptions, attitudes, and practices regarding their children's oral health in Kerala, India – A cross-Sectional study. JOURNAL OF NATURE AND SCIENCE OF MEDICINE 2022. [DOI: 10.4103/jnsm.jnsm_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Daoud E, Caimino C, Akeroyd MA, Noreña AJ, Baguley DM. The Utility of Economic Measures to Quantify the Burden of Tinnitus in Affected Individuals: A Scoping Review. PHARMACOECONOMICS - OPEN 2022; 6:21-32. [PMID: 34213755 PMCID: PMC8807799 DOI: 10.1007/s41669-021-00273-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Tinnitus is a chronic subjective condition that impacts patients' health-related quality of life (HRQoL) and requires multidisciplinary interventions. In health economics, quality-adjusted life years (QALYs) and willingness to pay (WTP) are essential for evaluating treatment effectiveness in cost-effectiveness, cost-utility, or cost-benefit analysis. The extent to which these economic measures have been used in tinnitus research has not been investigated. The objectives of this scoping review were to explore findings and limitations of existing studies and provide an insight into how these economic measures could be used to quantify the burden of tinnitus in affected individuals. METHODS A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodological framework. The search strategy involved four electronic databases. Records were included when QALYs or WTP were measured in individuals whose primary or secondary complaint was tinnitus. RESULTS A total of 15 studies were identified: three WTP assessment studies and 12 QALY assessment studies using direct preference-based measures (PBMs) (n = 4), indirect PBMs (n = 7), and a disease-specific psychometric instrument (n = 1). The limited use to date of PBMs to assess HRQoL in tinnitus patients is an important finding. CONCLUSIONS Further studies using reliable economic methods and focusing on patients' WTP for treatment or their preference for their current health state are needed. Applying PBMs in tinnitus research is crucial not only for the healthcare decision-making process but also to improve patient-centred care.
Collapse
Affiliation(s)
- Elza Daoud
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France.
| | - Charlotte Caimino
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Michael A Akeroyd
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Arnaud J Noreña
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - David M Baguley
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Audiology Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|
12
|
Engel L, Bryan S, Whitehurst DGT. Conceptualising 'Benefits Beyond Health' in the Context of the Quality-Adjusted Life-Year: A Critical Interpretive Synthesis. PHARMACOECONOMICS 2021; 39:1383-1395. [PMID: 34423386 DOI: 10.1007/s40273-021-01074-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
There is growing interest in extending the evaluative space of the quality-adjusted life-year framework beyond health. Using a critical interpretive synthesis approach, the objective was to review peer-reviewed literature that has discussed non-health outcomes within the context of quality-adjusted life-years and synthesise information into a thematic framework. Papers were identified through searches conducted in Web of Science, using forward citation searching. A critical interpretive synthesis allows for the development of interpretations (synthetic constructs) that go beyond those offered in the original sources. The final output of a critical interpretive synthesis is the synthesising argument, which integrates evidence from across studies into a coherent thematic framework. A concept map was developed to show the relationships between different types of non-health benefits. The critical interpretive synthesis was based on 99 papers. The thematic framework was constructed around four themes: (1) benefits affecting well-being (subjective well-being, psychological well-being, capability and empowerment); (2) benefits derived from the process of healthcare delivery; (3) benefits beyond the recipient of care (spillover effects, externalities, option value and distributional benefits); and (4) benefits beyond the healthcare sector. There is a wealth of research concerning non-health benefits and the evaluative space of the quality-adjusted life-year. Further dialogue and debate are necessary to address conceptual and normative challenges, to explore the societal willingness to sacrifice health for benefits beyond health and to consider the equity implications of different courses of action.
Collapse
Affiliation(s)
- Lidia Engel
- Faculty of Health, Deakin University, Burwood, VIC, Australia.
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
| | - Stirling Bryan
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - David G T Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| |
Collapse
|
13
|
Kaambwa B, Chen G, Khadka J, Milte R, Mpundu-Kaambwa C, Woods TJ, Ratcliffe J. A preference for quality: Australian general public's willingness to pay for home and residential aged care. Soc Sci Med 2021; 289:114425. [PMID: 34673356 DOI: 10.1016/j.socscimed.2021.114425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 02/04/2023]
Abstract
In Australia and many other countries internationally, aged care services are provided to older people in their own homes or residential care facilities. The majority of these services are funded by the federal government using taxpayer contributions from the general public. However, the monetary value Australians place on aged care services, and the factors that predict this value, have not been examined. We, therefore, sought to determine the general public's willingness to pay (WTP) for aged care services and examine which factors influence this WTP. A cross-sectional contingent valuation survey was administered to a nationally representative cohort of 10,285 Australians between September and October 2020 from the general population aged 18 years and over. Respondents were asked to indicate their WTP values for satisfactory and high-quality aged care services to be provided in the future. A two-part regression model was used to explain what factors explained variation in WTP. In total, 80% (61%) of respondents were willing to pay to access satisfactory (high) quality home care (counterpart figures for residential care were 64% (45%)). On average, respondents were willing to pay between $126 and $158 ($145 and $237) per week to receive satisfactory-quality (high-quality) home care and between $333 and $520 ($308 and $680) per week for satisfactory-quality (high-quality) residential care. Respondents were willing to pay an additional $120 per week on average to access high-quality aged care. Higher WTP values were generally associated with being younger, male, recent experience with aged care through a close family member accessing aged care and ability to pay. These results suggest general public support for payment of individual co-contributions to access aged care services in the future.
Collapse
Affiliation(s)
- Billingsley Kaambwa
- Health Economics, College of Medicine & Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, South Australia, 5042, Australia.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, 3145, Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, 5000, Australia
| | - Rachel Milte
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Taylor-Jade Woods
- Health Economics, College of Medicine & Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| |
Collapse
|
14
|
Isah A, Adibe MO, Abba A, Dim OF, Ekwuofu AA, Ma'aji HU, Ukwe CV, Udeogaranya PO, Okonta MJ. How do patients prefer specialized clinical pharmacy service to other prevention of mother-to-child transmission of human immunodeficiency virus services? An evaluation of their willingness to pay and willingness to accept choices and ratios. J Clin Pharm Ther 2021; 46:1695-1705. [PMID: 34448210 DOI: 10.1111/jcpt.13519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/31/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Donor agencies provide most of the funds for HIV services in developing countries. Due to the global economic downturn, there has been a reduction in funding for HIV-related services in Nigeria. This study compared the willingness to pay (WTP)-willingness to accept (WTA) ratios for prevention of mother-to-child transmission (PMTCT) services to specialized clinical pharmacy services among patients of two Nigerian hospitals. METHODS This was a cross-sectional survey using contingent valuation method at Ahmadu Bello University Teaching Hospital (ABUTH) and University of Nigeria Teaching Hospital (UNTH). WTP and WTA were elicited using an interviewer-administered questionnaire and a payment card. The responses to the WTP and WTA questions were reported as frequencies and percentages, while the amounts were determined as mean. All costs were obtained in Nigerian Naira (N360 = $1). RESULTS AND DISCUSSION Of the 219 mothers who participated in the study, 172 (78.5%) had no health insurance. Primary prevention of HIV (PPV) had the highest "yes" WTP response of 152 (69.4%) and the highest mean WTP amount of N6067.20. It also had the least "no" WTA response of 162 (74.0%) and the least WTA amount of N232.09. Specialized clinical pharmacy service (SCPS) had the highest WTA/WTP ratio of 4.0826 in ABUTH and 9.3750 at UNTH. Its income effect was -3.0826. A 1% increase in income led to 0.0550 (95% CI: -0.3068 to 0.1968) decreased odds to pay for PPV. WHAT IS NEW AND CONCLUSION Most patients assessed in this study were willing to pay for PPV than other services. Majority of them were also willing to forgo PMTCT Drugs Only. SCPS had the highest value for the patients, but they did not want to pay a high amount for it. Employment status, health insurance status, educational level and age were predictors of patients' WTP and WTA.
Collapse
Affiliation(s)
- Abdulmuminu Isah
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Maxwell Ogochukwu Adibe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Abubakar Abba
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Obinna Felix Dim
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Azubuike Amos Ekwuofu
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Hadiza Usman Ma'aji
- Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Chinwe Victoria Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Patrick Obinna Udeogaranya
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Mathew Jegbefume Okonta
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| |
Collapse
|
15
|
Snoswell CL, Whitty JA, Caffery LJ, Kho J, Horsham C, Loescher LJ, Vagenas D, Gillespie N, Soyer HP, Janda M. Consumer Preference and Willingness to Pay for Direct-to-Consumer Mobile Teledermoscopy Services in Australia. Dermatology 2021; 238:358-367. [PMID: 34515087 DOI: 10.1159/000517257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/18/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia. METHODS Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences. RESULTS The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18-73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1-20 or AUD 21-40. CONCLUSION Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions.
Collapse
Affiliation(s)
- Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.,School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer A Whitty
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.,Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Joanna Kho
- UQ Business School, The University of Queensland, Brisbane, Queensland, Australia
| | - Caitlin Horsham
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lois J Loescher
- College of Nursing, Arizona Cancer Center, and Skin Cancer Institute at The University of Arizona, Tucson, Arizona, USA
| | - Dimitrios Vagenas
- Institute of Health and Biomedical Innovation, Directorate, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nicole Gillespie
- UQ Business School, The University of Queensland, Brisbane, Queensland, Australia
| | - H Peter Soyer
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Monika Janda
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
16
|
Burge AT, Holland AE, McDonald CF, Hill CJ, Lee AL, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahhama A, Gillies R, Mahald A. "Willingness to Pay": The Value Attributed to Program Location by Pulmonary Rehabilitation Participants. COPD 2021; 18:281-287. [PMID: 34060968 DOI: 10.1080/15412555.2021.1924127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The "contingent valuation" method is used to quantify the value of services not available in traditional markets, by assessing the monetary value an individual ascribes to the benefit provided by an intervention. The aim of this study was to determine preferences for home or center-based pulmonary rehabilitation for participants with chronic obstructive pulmonary disease (COPD) using the "willingness to pay" (WTP) approach, the most widely used technique to elicit strengths of individual preferences. This is a secondary analysis of a randomized controlled equivalence trial comparing center-based and home-based pulmonary rehabilitation. At their final session, participants were asked to nominate the maximum that they would be willing to pay to undertake home-based pulmonary rehabilitation in preference to a center-based program. Regression analyses were used to investigate relationships between participant features and WTP values. Data were available for 141/163 eligible study participants (mean age 69 [SD 10] years, n = 82 female). In order to undertake home-based pulmonary rehabilitation in preference to a conventional center-based program, participants were willing to pay was mean $AUD176 (SD 255) (median $83 [IQR 0 to 244]). No significant difference for WTP values was observed between groups (p = 0.98). A WTP value above zero was related to home ownership (odds ratio [OR] 2.95, p = 0.02) and worse baseline SF-36 physical component score (OR 0.94, p = 0.02). This preliminary evidence for WTP in the context of pulmonary rehabilitation indicated the need for further exploration of preferences for treatment location in people with COPD to inform new models of service delivery.
Collapse
Affiliation(s)
- Angela T Burge
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Catherine J Hill
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Annemarie L Lee
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Narelle S Cox
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Australia
| | | | - Caroline Nicolson
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Paul O'Halloran
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Aroub Lahhama
- Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Rebecca Gillies
- Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Ajay Mahald
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
17
|
Cerda AA, García LY. Willingness to Pay for a COVID-19 Vaccine. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:343-351. [PMID: 33619688 PMCID: PMC7899739 DOI: 10.1007/s40258-021-00644-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has considerably affected the lives of people worldwide, impacting their health and economic welfare, and changing the behavior of our society significantly. This situation may lead to a strong incentive for people to buy a vaccine. Therefore, a relevant study to assess individuals' choices and the value of change in welfare from a COVID-19 vaccine is essential. OBJECTIVE This study aimed to estimate the willingness-to-pay (WTP) value for a vaccine for COVID-19. We also identify the variables that influence individual vaccination decisions, which could be used in the design of vaccination promotion strategies. METHODS We use the contingent valuation method in its double-bounded dichotomous choice format. The estimation coefficients are calculated according to the maximum likelihood method under the assumption of a probit distribution. The sample consisted of 531 individuals, mainly from middle- and high-income socioeconomic groups from Chile between enrolled between 10 July and 10 August 2020. RESULTS The results show a high WTP for the COVID-19 vaccine, with a value up to US$232. Income and education levels and having family members with COVID-19 increased the likelihood of persons paying for a vaccine. There is also a greater fear as the pandemic progresses that people will get sick from COVID-19. CONCLUSIONS The high WTP value creates an opportunity for formulating public health policy. The results of this study suggest that governments can provide the vaccine free to low-income groups and allow those with higher incomes to acquire the vaccine through the private sector by paying. This will be useful especially for countries with economic difficulties.
Collapse
Affiliation(s)
- Arcadio A. Cerda
- Faculty of Economics and Business, University of Talca, 1 Poniente 1141, Talca, Chile
| | - Leidy Y. García
- Faculty of Economics and Business, University of Talca, 1 Poniente 1141, Talca, Chile
| |
Collapse
|
18
|
Alharbi NS. Determinants of Willingness to pay for Employment-Based Health Insurance Among Governmental School Workers in Saudi Arabia. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021; 58:469580211060790. [PMID: 34798799 PMCID: PMC8606973 DOI: 10.1177/00469580211060790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
School workers constitute the bulk of public workers in Saudi Arabia. Most of these workers seek public health care services through the Ministry of Health, which is characterised by an overloaded service. Consequently, the government is planning to introduce employment-based health insurance. However, government employees’ willingness to pay (WTP) for health insurance was not investigated. This study explores the feasibility and acceptability of employment-based health insurance by examining public school workers’ WTP. Methods: six hundred and twenty-second number participants from Riyadh city were interviewed from September to October 2020 using an online structured questionnaire. The contingent valuation method with a payment card was used to assess WTP among the participants. This study also determined the association between the willingness to participate and WTP for health insurance respondents’ demographic and socio-economic characteristics. Chi-square and multiple linear regression analyses were used to analyse the data. The majority (76%) with an average monthly mean of 77.9 Saudi Riyal (SAR) ($20.7) per capita. Male, had higher educated, and those diagnosed with chronic disease were more likely to report a willingness to participate and/or pay for health insurance (P > .005). This study demonstrates that WTP for employment-based health insurance depends on workers’ characteristics. The results of this study may be of use to policymakers to help with a set insurance premium, priority setting and fund allocation.
Collapse
Affiliation(s)
- Nouf Sahal Alharbi
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
19
|
Hajek A, Enzenbach C, Stengler K, Glaesmer H, Hinz A, Röhr S, Stein J, Riedel-Heller SG, König HH. Determinants of Willingness to Pay for Health Insurance in Germany-Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). Front Public Health 2020; 8:456. [PMID: 32984246 PMCID: PMC7485392 DOI: 10.3389/fpubh.2020.00456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis (n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about €240 which corresponds to ~14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population.
Collapse
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Cornelia Enzenbach
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Katarina Stengler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Helios Park Hospital Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
20
|
Rezaei S, Woldemichael A, Mirzaei M, Mohammadi S, Karami Matin B. Mothers' willingness to accept and pay for vaccines to their children in western Iran: a contingent valuation study. BMC Pediatr 2020; 20:307. [PMID: 32576156 PMCID: PMC7310440 DOI: 10.1186/s12887-020-02208-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/16/2020] [Indexed: 12/28/2022] Open
Abstract
Background The clients’ willingness to accept (WTA) and willingness to pay (WTP) for a given good or service can help elicit the monetary value of that good or service. This study aims to assess the WTA and WTP of mothers attending primary health centers for vaccines to their children during 2019 in Kermanshah city, western Iran. Methods We conducted a cross-sectional study on a total of 667 mothers attending primary health centers for vaccines to their children aged two to 18 months. A multistage sampling technique was employed to involve the mothers in the study, and data were collected using a self-administrated open-ended questionnaire. The multivariate linear regression model was used to identify the factors associated with the mothers’ WTP and WTA for vaccines to their children. Results The study indicated that 94.2 and 93.1% of the mothers respectively had WTA and WTP values greater than zero, with their corresponding mean values of US$ 6.8 and US$ 4.4. The mothers in the higher monthly household income category, mothers born in the urban areas, and being a female child showed statistically significant positive associations with the mothers’ WTA for the vaccines. While there was a statistically significant positive relationship between monthly household income and the mothers’ WTP; a statistically significant negative relationship exists between the mothers’ age and their WTP for the vaccine to their children. Conclusions The findings indicated the mothers’ WTA to WTP ratio of greater than one for the vaccines to their children. The most important factor associated with the mothers’ WTA and WTP was the monthly household income. Thus, improving the socio-economic standards of women in the study area might contribute to reinforcing their immunization services seeking behavior to their children.
Collapse
Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abraha Woldemichael
- Department of Health Systems, School of Public Health, College of Health Sciences, Mek'ele University, Mek'ele, Ethiopia
| | - Masoumeh Mirzaei
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Mohammadi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
21
|
Lauer R, Traub M, Hansen S, Kilian R, Steinacker JM, Kesztyüs D. Longitudinal changes and determinants of parental willingness to pay for the prevention of childhood overweight and obesity. HEALTH ECONOMICS REVIEW 2020; 10:15. [PMID: 32468490 PMCID: PMC7257510 DOI: 10.1186/s13561-020-00266-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Willingness to Pay (WTP) is an alternative to measure quality-adjusted life years for cost-effectiveness analyses. The aim was to evaluate longitudinal changes and determinants of parental WTP for the prevention of childhood overweight and obesity. METHODS Longitudinal data from post- (T2) and follow-up (T3) measurements of a school-based health promotion program in Germany. Parental questionnaires included general WTP and the corresponding amount to reduce incidental childhood overweight and obesity by half. Longitudinal differences were examined with the McNemar test for general WTP and the Wilcoxon signed-rank test for the amount of WTP. Regression analyses were conducted to detect determinants. RESULTS General parental WTP significantly decreased from 48.9% to 35.8% (p < 0.001, n = 760). Logistic regression analysis (n = 561) showed that parents with a tertiary education level and a positive general WTP at T2, families with a higher monthly household income, and those with abdominally obese children were significant predictors of general WTP at T3. Median amount of WTP at T3 was €20.00 (mean = €27.96 ± 26.90, n = 274). Assuming a WTP of €0 for those who were generally not willing to pay or did not answer, resulted in a median amount of WTP at T3 of €0 (m = €8.45, sd = €19.58, n = 906). According to linear regression analysis WTP at T2 was the only significant predictor for the amount of WTP at T3 (p = 0.000, n = 181). CONCLUSIONS Despite the decline of general WTP, these results are a reflection of the public awareness of the problem and the need for action. Policy makers should recognize this and initiate sustainable public preventive strategies. TRIAL REGISTRATION DRKS, DRKS00000494. Registered 25 August 2010, https://www.drks.de/drks_web/.
Collapse
Affiliation(s)
- Romy Lauer
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | - Meike Traub
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
- Department of University Sports / Workplace Health Management, Ulm University, Ulm, Germany
| | - Sylvia Hansen
- Ceres - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Unversity of Cologne, Cologne, Germany
| | - Reinhold Kilian
- Section Health Economics and Health Services Research, Department of Psychiatry II, Ulm University Medical Center, Günzburg, Germany
| | | | - Dorothea Kesztyüs
- Division of Sport and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
- Institute of General Practice, Ulm University Medical Center, Ulm, Germany
| |
Collapse
|
22
|
Anosike C, Adibe MO, Isah A, Ukoha-Kalu OB. Willingness to pay for pharmacist-provided home telemonitoring among patients with chronic diseases in Enugu metropolis. Health Informatics J 2019; 26:829-840. [PMID: 31195915 DOI: 10.1177/1460458219852534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Home telemonitoring is a promising approach in the management of patients with chronic diseases. However, no study has assessed its acceptability and possible service charge in Nigeria. Therefore, this study aimed to evaluate willingness to pay for pharmacist-provided telemonitoring among patients with chronic diseases and to explore its determinants. Hence, using the contingent valuation method, a cross-sectional study was conducted among eligible patients visiting 15 selected community pharmacies in Enugu metropolis, over a period of 3 months. Of the 335 patients who participated in the study, about 40 percent (i.e. 39.4%) were willing to pay an average monthly fee of ₦915.91 ± 485.49 (US$2.99 ± 1.59) for home telemonitoring services. Significant predictors of willingness to pay for home telemonitoring were perceived insufficient income (odds ratio = 0.20, 95% confidence interval = 0.07-0.60, p = 0.040) and health insurance status (odds ratio = 0.39, 95% confidence interval = 0.18-0.86, p = 0.019). Our findings suggest a promising potential for adopting home telemonitoring services among patients with chronic diseases in Enugu metropolis.
Collapse
|
23
|
Gospodarevskaya E, Carter R, Imms C, Chu EMY, Nicola-Richmond K, Gribble N, Froude E, Guinea S, Sheppard L, Iezzi A, Chen G. Economic evaluation of simulated and traditional clinical placements in occupational therapy education. Aust Occup Ther J 2019; 66:369-379. [PMID: 30680738 DOI: 10.1111/1440-1630.12563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This economic evaluation complements results of the randomised controlled trial that established non-inferiority of the learning outcomes of a one-week simulated clinical placement (SCP) in occupational therapy qualifying degrees in comparison to an equivalent traditional clinical placement (TCP). This companion study presents detailed cost analyses of two placement alternatives and a cost-benefit study to assess the value for money of SCP. An economic evaluation of simulated versus traditional placements has not previously been conducted in Australia. METHODS Nine SCP/TCP rounds were conducted by six Australian universities. Costs were collected using study-specific instruments. Public health sector costs were sourced from available literature. Willingness-to-pay for SCP/TCP was estimated using both a Discrete Choice Experiment and a Contingent Valuation method. These methods were employed to assess a comparative 'value' of SCP/TCP from the perspective of heads of occupational therapy departments (N = 28), who were asked to put a monetary value on the broader range of benefits associated with SCP/TCP. RESULTS From the universities' perspective the average cost per student ranged from AUD$460 to AUD$1511 for simulated and AUD$144 to AUD$1112 for traditional placement. From the health care sector perspective, the difference in costs favoured simulated placements for four implementations and traditional placements for five. In the Discrete Choice Experiment respondents preferred traditional rather than simulated placement and would pay additional AUD$533. The estimated monetary value of simulated placements from a contingent valuation ranged from AUD$200 to AUD$1600. CONCLUSIONS For universities that procure TCPs predominately at public health care facilities and sustain high administrative overheads, the SCP program could be a cost-saving alternative. From a broader value-for-money perspective, respondents favoured TCP over SCP, yet placed importance on placement availability and opportunity to demonstrate competence for students during the placement. Results should be interpreted with caution and further research with larger sample sizes is required.
Collapse
Affiliation(s)
- Elena Gospodarevskaya
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
| | - Rob Carter
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
| | - Christine Imms
- School of Allied Health, Australian Catholic University, Fitzroy, VIC, Australia
| | | | | | - Nigel Gribble
- School of Occupational Therapy, Social Work, and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Elspeth Froude
- School of Allied Health, Australian Catholic University, Fitzroy, VIC, Australia
| | - Stephen Guinea
- Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Loretta Sheppard
- School of Allied Health, Australian Catholic University, Fitzroy, VIC, Australia
| | - Angelo Iezzi
- School of Occupational Therapy, Social Work, and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Clayton, VIC, Australia
| |
Collapse
|
24
|
Isaranuwatchai W, Bayoumi AM, Renahy E, Cheff R, O'Campo P. Using decision methods to examine the potential impact of intersectoral action programs. BMC Res Notes 2018; 11:506. [PMID: 30053829 PMCID: PMC6062875 DOI: 10.1186/s13104-018-3609-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/17/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives In public health today, there is a widespread call for intersectoral action (ISA) programs, in which two or more sectors cooperate to address a problem. This trend raises a question of how to appropriately assess the effectiveness and cost-effectiveness of ISA programs. To assess the impact of ISA, evaluation methods should provide a framework for simultaneously considering the impact of two or more interventions when selecting from a portfolio of programs. There is a gap in literature on such methods. In this research note, from a narrative review, we report and describe methods that could be useful for evaluating ISA programs. Subsequently, we present a hypothetical case study to demonstrate the use of these methods. Results We identified four methods that have potential to assess the joint impact of multiple interventions: economic evaluation, portfolio analysis, multiple-criteria decision analysis, and programme budgeting and marginal analysis. To keep pace with the desire to use strong evidence to inform the selection and design of ISA programs, methods must evolve to support these initiatives. This research note seeks to begin a dialogue on existing decision methods which may be used to assist decision makers with funding and resource allocation decisions of ISA programs. Electronic supplementary material The online version of this article (10.1186/s13104-018-3609-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Wanrudee Isaranuwatchai
- Centre for Excellence in Economic Analysis Research (CLEAR), The HUB, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada.
| | - Ahmed M Bayoumi
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada.,Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.,Department of Medicine, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada.,Division of General Internal Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Emilie Renahy
- Lea Roback Research Centre on Social Inequalities and Health, 1301, rue Sherbrooke Est, Montreal, QC, H2L 1M3, Canada.,Département de médecine sociale et préventive, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| | - Rebecca Cheff
- Wellesley Institute, 10 Alcorn Ave, Toronto, ON, M4V 3B1, Canada
| | - Patricia O'Campo
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.,Dalla Lana School of Public Health, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada
| |
Collapse
|
25
|
Webers C, Essers I, van Tubergen A, Braun J, Heldmann F, Baraliakos X, Boonen A. Valuing Treatment With Infliximab for Ankylosing Spondylitis Using a Willingness-to-Pay Approach. Arthritis Care Res (Hoboken) 2018; 70:608-616. [PMID: 28575536 PMCID: PMC5901401 DOI: 10.1002/acr.23299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 06/01/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate willingness to pay (WTP) for treatment with infliximab by patients with ankylosing spondylitis (AS) and explore factors associated with WTP. METHODS Data from 85 patients participating in the European AS Infliximab Cohort (EASIC) open-label extension of the AS Study for the Evaluation of Recombinant Infliximab Therapy (ASSERT) were used. WTP was included at baseline in EASIC and comprised a hypothetical scenario exploring whether the patient would be willing to pay for beneficial effects of infliximab and, if so, what amount they would be willing to pay per administration. Factors associated with WTP were explored using zero-inflated negative binomial (ZINB) regressions. RESULTS Of the 85 patients, 63 (74.1%) were willing to pay, and among these, the mean amount they were willing to pay per administration was €275 (median €100 [interquartile range €50-200]). Multivariable ZINB analysis showed that Assessment of SpondyloArthritis international Society criteria for 20% improvement (ASAS20) response was associated with a 7-fold lower likelihood to pay 0 euros (odds ratio [OR] 0.14 [95% confidence interval (95% CI) 0.03-0.71]) and a 3-fold increase in the amount willing to pay (exp(β) = 3.32 [95% CI 1.44-7.69]). In addition, the country of residence was associated with a lower likelihood to pay 0 euros (OR 0.07 [95% CI 0.02-0.36]), while increased age was associated with the amount willing to pay (exp(β) = 1.05 [95% CI 1.01-1.09]). CONCLUSION In a hypothetical scenario, three-quarters of patients with AS receiving long-term infliximab stated that they were willing to pay an out-of-pocket contribution for this treatment. Treatment response contributed to the willingness as well as to the amount patients were willing to pay.
Collapse
Affiliation(s)
- Casper Webers
- Maastricht University Medical Center and School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ivette Essers
- Maastricht University Medical Center and School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Astrid van Tubergen
- Maastricht University Medical Center and School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | | | | | - Annelies Boonen
- Maastricht University Medical Center and School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
26
|
Berendsen J, Bonifacio C, van Gemert-Schriks M, van Loveren C, Verrips E, Duijster D. Parents' willingness to invest in their children's oral health. J Public Health Dent 2017; 78:69-77. [PMID: 28749530 DOI: 10.1111/jphd.12242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/30/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to evaluate parents' Willingness to Invest (WTI) in their children's oral health in terms of money, visits to a dental practice, and brushing minutes. Objectives were to assess the association between parents' WTI and a) children's dental caries experience, b) children's oral hygiene behavior (OHB), and c) maternal education level and ethnic background. METHODS A sample of 630 five to six-year-old-children was recruited from pediatric dental centers in the Netherlands. Children's dmft scores were extracted from personal dental records. Parental questionnaires were used to collect data on parents' WTI, children's OHB, maternal education level and ethnicity. RESULTS On average, parents were willing to spend a maximum of €37 per month, 3.0 dental visits per year, and 4.5 brushing minutes per day to maintain good oral health for their child. The mean dmft was significantly higher in children whose parents were willing to pay more money and visit the dentist more often (P = 0.028 and P = 0.002, respectively), while the mean dmft was significantly lower in children of parents who were willing to invest more brushing minutes (P < 0.001). Parental WTI in terms of money and brushing minutes was higher in native and higher-educated parents, and was associated with more favorable OHB of children. CONCLUSIONS Parents' WTI in their children's oral health is related to children's dental caries status and reported OHB. Results suggest that children are better off when parents are willing to invest in self-care, rather than in money or dental visits.
Collapse
Affiliation(s)
- Jannetje Berendsen
- Department of Cariology, Endodontology and Pedodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Clarissa Bonifacio
- Department of Cariology, Endodontology and Pedodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Martine van Gemert-Schriks
- Department of Cariology, Endodontology and Pedodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Cor van Loveren
- Department of Cariology, Endodontology and Pedodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Erik Verrips
- Lifestyle, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, Netherlands
| | - Denise Duijster
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| |
Collapse
|
27
|
Borges AP, Reis A, Anjos J. Willingness to pay for other individuals' healthcare expenditures. Public Health 2017; 144:64-69. [PMID: 28274386 DOI: 10.1016/j.puhe.2016.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/22/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The need to improve the sustainability of public health expenditure, in a climate of growing pressure on national budgets, inevitably leads to a discussion about resource rationing, and the extent of society's responsibility for those expenditures. To contribute to this discussion empirically, this study evaluated the willingness of Portuguese respondents to pay for other individuals' healthcare expenditures through out-of-pocket payments. STUDY DESIGN A questionnaire addressed to the general public was developed, with 296 respondents. The survey was divided into three sections: (i) sociodemographic characteristics of the respondents; (ii) health-related habits; and (iii) willingness to pay other individuals' healthcare expenditures and, if so, how much. METHODS Logit and ordered logit models were applied. RESULTS Respondents were divided fairly even between those who were willing to pay for other individuals' healthcare expenditures and those who were not. Respondents with health insurance contracts were more willing to contribute, and the contribution value was higher. Having a degree-level education was associated with reduced willingness to pay for other individuals' healthcare expenditures, and reduced probability of paying a larger amount, which may be associated with holding individuals accountable for their choices. Considering self-reported risky behaviours, the respondents who consumed alcohol were more likely to be willing to pay for other individuals' healthcare expenditures, and to a greater extent, whereas smokers were less likely to pay larger amounts. These effects suggest that respondents with different unhealthy behaviours are not equally altruistic. CONCLUSIONS These findings highlight the need to combine health policy and social beliefs. The respondents seem to be interested to discuss healthcare funding, given that they agreed to reveal their willingness to pay for other individuals' healthcare expenditures. Moreover, respondents' sociodemographic characteristics and health-related behaviours play a role in their willingness to contribute to social well-being through healthcare expenditures. The differences observed denote that no agreement exists regarding the extent of society's responsibility.
Collapse
Affiliation(s)
- A P Borges
- Research Centre of ISAG, European Business School, Lusíada University - North, Porto, Portugal.
| | - A Reis
- Faculty of Economic University of Coimbra, Coimbra, Portugal
| | - J Anjos
- Lusíada University - North, Porto, Portugal
| |
Collapse
|
28
|
Comparing the validity of the payment card and structured haggling willingness to pay methods: The case of a diabetes prevention program in rural Kenya. Soc Sci Med 2016; 169:86-96. [PMID: 27701019 DOI: 10.1016/j.socscimed.2016.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 08/29/2016] [Accepted: 09/11/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND The objective of this study was to compare the theoretical validity of two willingness-to-pay (WTP) methods, the commonly used payment card (PC) and the recently developed structured haggling (SH), for estimating the potential benefits of a diabetes prevention program in rural Kenya. METHODS A convenience sample of adult residents from a rural county in Kenya (Kiambu), with no history of diabetes, was randomly assigned to one of two WTP methods, PC or SH, using structured face-to-face interviews from December 2011 to February 2012. RESULTS A total of 376 respondents completed the interviews using PC (n = 185) or SH (n = 191). More than 95% of respondents were willing to pay something for program access. The study showed that both methods were feasible in rural Kenya. SH resulted in a higher annual mean WTP than PC, Ksh504.05 (US$7.25) versus Ksh619.95 (US$5.90), respectively (p < 0.01). Based on theory, it was hypothesized that certain predisposing factors would result in greater WTP. Greater socio-economic status (measured using income proxies) resulted in greater unconditional WTP for both the PC and SH groups (t-tests and bivariate correlations) and conditional WTP (GLM models). GLM for PC showed being male, employed and having distant relatives with diabetes were significant predictors for WTP, while for SH being educated, employed and owning a vehicle were significant predictors. CONCLUSION Both PC and SH showed theoretical validity in rural Kenya. However, the use of SH over PC in rural Kenya may be the better choice given that SH more closely mirrors marketplace transactions in this setting and the use of SH resulted in more significant variables in the GLM models.
Collapse
|
29
|
Marđetko N, Kos M. Patients’ knowledge and attitude towards therapeutic reference pricing system in Slovenia. Int J Clin Pharm 2016; 38:1301-10. [DOI: 10.1007/s11096-016-0370-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 07/29/2016] [Indexed: 11/30/2022]
|
30
|
Aumann I, Treskova M, Hagemann N, von der Schulenburg JM. Analysis of Driving Factors of Willingness to Use and Willingness to Pay for Existing Pharmacological Smoking Cessation Aids Among Young and Middle-Aged Adults in Germany. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2016; 14:441-452. [PMID: 27021824 DOI: 10.1007/s40258-016-0239-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Smoking cessation is a challenging task with a high risk of relapse. Depending on the choice of medication and duration of therapy, the costs of using a smoking cessation aid can be high. Additionally, these costs are not covered by health insurance in Germany. Information on willingness to use (WTU) and willingness to pay (WTP) for smoking cessation aids is valuable for developing different smoking cessation strategies. OBJECTIVES The study analyses WTU and WTP for three pharmacological smoking cessation aids (nicotine replacement therapy (NRT), bupropion and varenicline) among young and middle-aged adults in Germany and attempts to determine their major driving factors. METHODS Two cross-sectional internet-based surveys of smokers over 18 years of age were conducted in 2014 and 2015 in Germany. Respondents were asked about smoking-related issues and WTU and WTP for each therapy. The contingent valuation method with payment cards was used to measure WTP. Descriptive statistics, logistical regression and accelerated failure-time regression models were performed. RESULTS The total sample size is 505. Half of the respondents are willing to use NRT and one-third are willing to use bupropion and/or varenicline. WTU induces positive WTP; however, the magnitude of WTP is beneath the market price. WTU significantly increases with a higher addiction level and if smokers have previously heard about the therapy. CONCLUSION This study indicates different points to be considered for policy development. Promotion information and improving awareness about medication aids might increase WTU, and development of monetary incentives for young smokers could create a better chance for successful smoking cessation.
Collapse
Affiliation(s)
- I Aumann
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany.
- Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), Member of the German Center for Lung Research (DZL), Hanover, Germany.
| | - M Treskova
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
| | - N Hagemann
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
| | - J-M von der Schulenburg
- Centre for Health Economics Research Hanover (CHERH), Leibniz University of Hanover, Otto-Brenner-Str.1, 30159, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hanover (BREATH), Member of the German Center for Lung Research (DZL), Hanover, Germany
| |
Collapse
|
31
|
Bock JO, Hajek A, Brenner H, Saum KU, Matschinger H, Haefeli WE, Schöttker B, Quinzler R, Heider D, König HH. A Longitudinal Investigation of Willingness to Pay for Health Insurance in Germany. Health Serv Res 2016; 52:1099-1117. [PMID: 27324300 DOI: 10.1111/1475-6773.12522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate factors affecting willingness to pay (WTP) for health insurance of older adults in a longitudinal setting in Germany. DATA SOURCES Survey data from a cohort study in Saarland, Germany, from 2008-2010 and 2011-2014 (n1 = 3,124; n2 = 2,761) were used. STUDY DESIGN Panel data were taken at two points from an observational, prospective cohort study. DATA COLLECTION WTP estimates were derived using a contingent valuation method with a payment card. Participants provided data on sociodemographics, lifestyle factors, morbidity, and health care utilization. PRINCIPAL FINDINGS Fixed effects regression models showed higher individual health care costs to increase WTP, which in particular could be found for members of private health insurance. Changes in income and morbidity did not affect WTP among members of social health insurance, whereas these predictors affected WTP among members of private health insurance. CONCLUSIONS The fact that individual health care costs affected WTP positively might indicate that demanding (expensive) health care services raises the awareness of the benefits of health insurance. Thus, measures to increase WTP in old age should target at improving transparency of the value of health insurances at the moment when individual health care utilization and corresponding costs are still relatively low.
Collapse
Affiliation(s)
- Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Herbert Matschinger
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Walter Emil Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Renate Quinzler
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Dirk Heider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
32
|
Bock JO, Heider D, Matschinger H, Brenner H, Saum KU, Haefeli WE, König HH. Willingness to pay for health insurance among the elderly population in Germany. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2016; 17:149-158. [PMID: 25526928 DOI: 10.1007/s10198-014-0663-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 11/27/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans. METHODS Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card. RESULTS Mean monthly WTP per capita for health insurance amounted to €260. This corresponded to about 20% of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly. DISCUSSION The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.
Collapse
Affiliation(s)
- Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Dirk Heider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Herbert Matschinger
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Straβe 55, 04103, Leipzig, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| |
Collapse
|
33
|
van Mastrigt GA, Paulus AT, Aarts MJ, Evers SM, Alayli-Goebbels AF. A qualitative study on the views of experts regarding the incorporation of non-health outcomes into the economic evaluations of public health interventions. BMC Public Health 2015; 15:954. [PMID: 26399520 PMCID: PMC4581076 DOI: 10.1186/s12889-015-2247-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 09/07/2015] [Indexed: 12/19/2022] Open
Abstract
Background Public health interventions can impact a broad number of outcomes, including both health and non-health outcomes (NHOs). However, although it is often acknowledged that it’s important to take NHOs into account in economic evaluation studies, in practice these are often neglected. To address this issue, our study investigated expert views regarding the incorporation of NHOs into the economic evaluations of public health interventions, by means of a qualitative study. Methods A purposive sampling method was used to recruit the experts in the field of health economics and/or public health for this study. Twenty-two semi-structured interviews were held. After recording, the interviews were transcribed verbatim and entered in Nvivo. The data was analyzed using a thematic analysis to identify all important themes mentioned by the experts. Data collection and analysis was continued until saturation was reached. Multiple coding and validity checks were performed to further strengthen the rigour of our methodology. Results Based on the expert interviews, the following overarching themes were identified; Theme 1: NHOs on the individual level, direct social level and societal level. Theme 2: Pros and Cons regarding the development of a new instrument to measure NHOs. Theme 3: The most important requirements for a new questionnaire to be developed for measuring broader outcomes. Theme 4: Alternative methods which could be used for measuring and valuating NHOs in economic evaluations for public health. Discussion Our research findings indicate that the importance of NHOs and the need to measure them are universally accepted. Most of the experts acknowledge the importance of measuring broader outcomes and support the development of a new instrument to measure these. The experts, who do not support the development of a new instrument, question its usefulness and feasibility; i.e., they are not sure whether it is possible to valuate NHOs. Furthermore, experts have strong and sometimes conflicting views on the specific requirements of a new instrument to be developed for measuring NHOs. They did not identify a single preferred alternative method for measurement and valuation. Conclusions Most experts find a wide range of NHOs important and are in favor of developing a new instrument for identifying and measuring NHOs. Hence, an open discussion needs to be initiated with experts and other stakeholders about which steps need to be taken to move forward.
Collapse
Affiliation(s)
- Ghislaine Apg van Mastrigt
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Aggie Tg Paulus
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Marie-Jeanne Aarts
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Silvia Maa Evers
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Adrienne Fg Alayli-Goebbels
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleueler Strasse 176-178, 50935, Cologne, Germany.
| |
Collapse
|
34
|
Predictors of willingness to pay for physical activity of socially vulnerable groups in community-based programs. SPRINGERPLUS 2015; 4:527. [PMID: 26405646 PMCID: PMC4575679 DOI: 10.1186/s40064-015-1336-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/10/2015] [Indexed: 12/02/2022]
Abstract
Willingness to pay (WTP) is used to assess individuals’ value attribution to health-related quality of life interventions. Little is known about predictors of WTP for sport and physical activity in socially vulnerable groups in community-based physical activity (CBHEPA) programs. This study addresses the questions: What is the WTP for sport and physical activity of participants in CBHEPA programs, expressed in WTPmoney and WTPtime? Which factors predict WTPmoney and WTPtime? From the literature, predictors for WTP for sport and physical activity were identified: (1) personal and socio-economic predictors: income, education, age, and ethnic origin, (2) health-related predictors: perceived health, life satisfaction, sense of coherence, self-efficacy, (3) sport and physical activity-related predictors: duration and frequency of participation, leisure-time sport or physical activity, sport club membership, enjoyment, and membership fee. Data were gathered for WTPmoney and WTPtime (n = 268) in 19 groups in an evaluation study of CBHEPA programs. Ordered probit was used for analyses. WTPmoney was a monthly average of €9.6. WTPtime was on average 17.6 min travel time. Income was found as predictor for both WTPmoney and WTPtime. Other predictors for WTPmoney were: duration and frequency of program participation, enjoyment, and (former) sport club membership. Low income and younger age were found as predictors for WTPtime. Predictors for WTPmoney are related to income and sport and physical activity experiences, for WTPtime to income and age. Short-term program satisfaction is probably more decisive for WTPmoney than long-term perspectives of improving health-related quality of life.
Collapse
|
35
|
Kesztyüs D, Lauer R, Schreiber AC, Kesztyüs T, Kilian R, Steinacker JM. Parents' willingness to pay for the prevention of childhood overweight and obesity. HEALTH ECONOMICS REVIEW 2014; 4:20. [PMID: 26208923 PMCID: PMC4883987 DOI: 10.1186/s13561-014-0020-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/12/2014] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To determine parental willingness-to-pay (WTP) for childhood obesity prevention. METHODS Cross-sectional data from the follow-up measurements (2011) of a health promotion programme in German primary schools. Data collection included anthropometric measurements of children and self-administered questionnaires for parents, including WTP assessment. Mann-Whitney U-Test was used for differences between groups, and regression analysis to identify factors associated with general WTP and amount of WTP. RESULTS From 1 534 parents, 97.8% considered overweight/obesity to be serious public health problems. A general WTP to reduce the incidence of childhood overweight/obesity by half, was declared by 48.8%. Parents of overweight/obese children showed with 61.4%, significantly more frequently, their general WTP than the others with 47.2% (p = 0.001). Mean WTP was <euro>23.04 (99% confidence interval (CI) [22.45; 23.75]) per month. Parents of centrally obese children showed significantly higher WTP than parents of the other children (p = 0.001). General WTP and the amount of WTP were associated with the central obesity of the child, migration status and household income. Additionally, general WTP was associated with maternal obesity. CONCLUSIONS Nearly half of the parents were willing to invest in prevention of obesity. The general WTP significantly occurs more often and with higher amount in affected parents.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- />Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, Ulm, D-89075 Germany
| | - Romy Lauer
- />Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, Ulm, D-89075 Germany
| | - Anja C Schreiber
- />Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, Ulm, D-89075 Germany
| | - Tibor Kesztyüs
- />Department of Computer Science, University of Applied Sciences, Ulm, Germany
| | - Reinhold Kilian
- />Section Health Economics and Health Services Research, Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Jürgen M Steinacker
- />Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, Ulm, D-89075 Germany
| |
Collapse
|
36
|
Oremus M, Tarride JE, Pullenayegum E, Clayton N, Raina P. Patients’ Willingness-to-Pay for an Alzheimer’s Disease Medication in Canada. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2013; 6:161-8. [DOI: 10.1007/s40271-013-0014-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
37
|
Martín-Fernández J, del Cura-González MI, Rodríguez-Martínez G, Ariza-Cardiel G, Zamora J, Gómez-Gascón T, Polentinos-Castro E, Pérez-Rivas FJ, Domínguez-Bidagor J, Beamud-Lagos M, Tello-Bernabé ME, Conde-López JF, Aguado-Arroyo Ó, Sanz-Bayona MT, Gil-Lacruz AI. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations. PLoS One 2013; 8:e62840. [PMID: 23626858 PMCID: PMC3633834 DOI: 10.1371/journal.pone.0062840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 03/27/2013] [Indexed: 11/19/2022] Open
Abstract
Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.
Collapse
Affiliation(s)
- Jesús Martín-Fernández
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste. Gerencia de Atención Primaria, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Franic DM, Bothe AK, Bramlett RE. A welfare economic approach to measure outcomes in stuttering: comparing willingness to pay and quality adjusted life years. JOURNAL OF FLUENCY DISORDERS 2012; 37:300-313. [PMID: 23218213 DOI: 10.1016/j.jfludis.2012.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/23/2012] [Accepted: 04/27/2012] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of this study was to compare two welfare outcome measures, willingness to pay (WTP) and quality adjusted life years (QALYs) gained, to measure outcomes in stuttering. METHOD Seventy-eight adult participants (74 nonstuttering and 4 persons with stuttering) completed one face-to-face structured interview regarding how much they would be willing to pay to alleviate severe stuttering in three interventions of varying impact. These data were compared with QALYs gained as calculated from time trade off (TTO) and standard gamble (SG) data. RESULTS Mean (median) WTP bids ranged from US $16,875 (8000), for an intervention resulting in improvement from severe stuttering to mild stuttering, to US $41,844 (10,000) for an intervention resulting in a cure of severe stuttering. These data were consistent with mean changes in QALYs for the same stuttering interventions ranging from 2.19 (using SG) to 18.42 (using TTO). CONCLUSIONS This study presents the first published WTP and QALY data for stuttering. Results were consistent with previous cost-of-illness data for stuttering. Both WTP and QALY measures were able to quantify the reduction in quality of life that occurs in stuttering, and both can be used to compare the gains that might be achieved by different interventions. It is widely believed that stuttering can cause reduced quality of life for some speakers; the introduction into this field of standardized metrics for measuring quality of life is a necessary step for transparently weighing the costs and consequences of stuttering interventions in economic analyses. EDUCATIONAL OBJECTIVES The reader will be able to (a) describe the underlying theoretical foundations for willingness to pay and quality adjusted life years, (b) describe the application of willingness to pay and quality adjusted life years for use in economic analyses, (c) compare and contrast the value of willingness to pay and quality adjusted life years in measuring the impact of stuttering treatment on quality of life, (d) interpret quality adjusted life years, and (e) interpret willingness to pay data.
Collapse
Affiliation(s)
- Duska M Franic
- Dept. of Clinical and Administrative Pharmacy, RC Wilson Building Room 260N, The University of Georgia, 250 W Green St, Athens, GA 30602-2354, USA.
| | | | | |
Collapse
|
39
|
Oremus M, Tarride JE, Raina P, Thabane L, Foster G, Goldsmith CH, Clayton N. The general public's willingness to pay for tax increases to support unrestricted access to an Alzheimer's disease medication. PHARMACOECONOMICS 2012; 30:1085-1095. [PMID: 22938161 DOI: 10.2165/11594180-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognitive and functional abilities. OBJECTIVE Our objective was to assess the general public's maximum willingness to pay ((M)WTP) for an increase in annual personal income taxes to fund unrestricted access to AD medications. METHODS We randomly recruited 500 Canadians nationally and used computer-assisted telephone interviewing to administer a questionnaire. The questionnaire contained four 'efficacy' scenarios describing an AD medication as capable of symptomatically treating cognitive decline or modifying disease progression. The scenarios also described the medication as having no adverse effects or a 30% chance of adverse effects. We randomized participants to order of scenarios and willingness-to-pay bid values; (M)WTP for each scenario was the highest accepted bid for that scenario. We conducted linear regression and bootstrap sensitivity analyses to investigate potential determinants of (M)WTP. RESULTS Mean (M)WTP was highest for the 'disease modification/no adverse effects' scenario ($Can130.26) and lowest for the 'symptomatic treatment/30% chance of adverse effects' scenario ($Can99.16). Bootstrap analyses indicated none of our potential determinants (e.g. age, sex) were associated with participants' (M)WTP. CONCLUSIONS The general public is willing to pay higher income taxes to fund unrestricted access to AD (especially disease-modifying) medications. Consequently, the public should favour placing new AD medications on public drug plans. As far as we are aware, no other study has elicited the general public's willingness to pay for AD medications.
Collapse
Affiliation(s)
- Mark Oremus
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
| | | | | | | | | | | | | |
Collapse
|
40
|
Maloney S, Haas R, Keating JL, Molloy E, Jolly B, Sims J, Morgan P, Haines T. Breakeven, cost benefit, cost effectiveness, and willingness to pay for web-based versus face-to-face education delivery for health professionals. J Med Internet Res 2012; 14:e47. [PMID: 22469659 PMCID: PMC3376523 DOI: 10.2196/jmir.2040] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 02/13/2012] [Accepted: 02/06/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. OBJECTIVE To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals. METHODS We designed two short courses to improve the clinical performance of health professionals in exercise prescription for falls prevention. One was developed for delivery in face-to-face mode and the other for online learning. Data were collected on learning outcomes including participation, satisfaction, knowledge acquisition, and change in practice, and combined with costs, savings, and benefits, to enable a break-even analysis from the perspective of the provider, cost-effectiveness analysis from the perspective of the health service, and cost-benefit analysis from the perspective of the participant. RESULTS Face-to-face and Web-based delivery modalities produced comparable outcomes for participation, satisfaction, knowledge acquisition, and change in practice. Break-even analysis identified the Web-based educational approach to be robustly superior to face-to-face education, requiring a lower number of enrollments for the program to reach its break-even point. Cost-effectiveness analyses from the perspective of the health service and cost-benefit analysis from the perspective of the participant favored face-to-face education, although the outcomes were contingent on the sensitivity analysis applied (eg, the fee structure used). CONCLUSIONS The Web-based educational approach was clearly more efficient from the perspective of the education provider. In the presence of relatively equivocal results for comparisons from other stakeholder perspectives, it is likely that providers would prefer to deliver education via a Web-based medium. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN): 12610000135011; http://www.anzctr.org.au/trial_view.aspx?id=335135 (Archived by WebCite at http://www.webcitation.org/668POww4L).
Collapse
|
41
|
Willingness to pay for one-stop anesthesia in pediatric day surgery. Ital J Pediatr 2011; 37:23. [PMID: 21586162 PMCID: PMC3121670 DOI: 10.1186/1824-7288-37-23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 05/17/2011] [Indexed: 11/30/2022] Open
Abstract
Background This study assesses the parents' Willingness To Pay (WTP) for One Stop Anesthesia (OSA). OSA is part of a free screening procedure that determines the timing of the anesthesiological assessment. In OSA-positive patients, the preoperative assessment is carried out on the same day as the surgery. The OSA allows patients who have to undergo surgery in a pediatric day surgery to avoid accessing the pre-admission clinic. Method This is a descriptive cohort study. A sample of 106 parents were interviewed directly by means of a questionnaire. The questionnaire builds a hypothetical scenario where the interviewee has a chance to buy the OSA health service with the WTP. The WTP values are distributed in classes and are contingent to the market built in the questionnaire. The Chi Square and Cramer's V tests evaluate the WTP dependence on the parents' place of origin and occupation. Results The approximate average of the WTP classes is €87.21 per family. The Chi Square test relative to the WTP classes and the places of origin is statistically significant (p < 0.05). The Cramer's V test is 0.347 and points to a positive association between the two demographics. The Cramer's V test of the WTP classes and the types of job is 0.339 and indicates a positive association. Conclusion Nearly 90% of pediatric patients who were screened for timing the preoperative assessment are true positives to OSA. This allows doing away with the pre-hospitalization, with definite advantages for the families. This screening is a health service that families would be hypothetically willing to pay.
Collapse
|
42
|
Jarahi L, Karbakhsh M, Rashidian A. Parental willingness to pay for child safety seats in Mashad, Iran. BMC Public Health 2011; 11:281. [PMID: 21548995 PMCID: PMC3110571 DOI: 10.1186/1471-2458-11-281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 05/08/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Iran has one of the highest rates of road traffic crash death rates throughout the world and road traffic injuries are the leading cause of years of life lost in the country. Using child car safety seats is not mandatory by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashad, the second most populated city in Iran with one of the highest rates of road traffic-related deaths. METHODS We surveyed 590 car-owner parents of kindergarten children who were willing to participate in the study in the year 2009. We asked them about the maximum amount of money they were willing to pay for car safety seats using contingent valuation method. RESULTS The mean age of children was 33.5 months. The median parental WTP for CSS was about $15. Considering the real price of CSSs in Iran, only 12 percent of responders could be categorized as being willing to pay for it. Family income level was the main predictor of being willing to pay. CONCLUSIONS The median parental WTP was much lower than the actual price of the safety seats, and those who were of lower socio-economic class were less willing to pay. Interventions to increase low-income families' access to child safety seats such as providing free of charge or subsidized seats, renting or health insurance coverage should be considered.
Collapse
Affiliation(s)
- Lida Jarahi
- Sina Trauma Research Center, Tehran University of Medical Sciences, Iran
| | | | | |
Collapse
|
43
|
Haines TP, McPhail S. Patient preference for falls prevention in hospitals revealed through willingness-to-pay, contingent valuation survey. J Eval Clin Pract 2011; 17:304-10. [PMID: 21040242 DOI: 10.1111/j.1365-2753.2010.01441.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Patient preference for interventions aimed at preventing in-hospital falls has not previously been investigated. This study aims to contrast the amount patients are willing to pay to prevent falls through six intervention approaches. METHODS This was a cross-sectional willingness-to-pay (WTP), contingent valuation survey conducted among hospital inpatients (n = 125) during their first week on a geriatric rehabilitation unit in Queensland, Australia. Contingent valuation scenarios were constructed for six falls prevention interventions: a falls consultation, an exercise programme, a face-to-face education programme, a booklet and video education programme, hip protectors and a targeted, multifactorial intervention programme. The benefit to participants in terms of reduction in risk of falls was held constant (30% risk reduction) within each scenario. RESULTS Participants valued the targeted, multifactorial intervention programme the highest [mean WTP (95% CI): $(AUD)268 ($240, $296)], followed by the falls consultation [$215 ($196, $234)], exercise [$174 ($156, $191)], face-to-face education [$164 ($146, $182)], hip protector [$74 ($62, $87)] and booklet and video education interventions [$68 ($57, $80)]. A 'cost of provision' bias was identified, which adversely affected the valuation of the booklet and video education intervention. CONCLUSION There may be considerable indirect and intangible costs associated with interventions to prevent falls in hospitals that can substantially affect patient preferences. These costs could substantially influence the ability of these interventions to generate a net benefit in a cost-benefit analysis.
Collapse
Affiliation(s)
- Terry P Haines
- Allied Health Clinical Research Unit, Southern Health, Cheltenham, Victoria, Australia and Director of Research, Southern Physiotherapy Clinical School, Monash University Physiotherapy Department, Frankston, Victoria, Australia.
| | | |
Collapse
|
44
|
Abstract
This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value.
Collapse
Affiliation(s)
- Steven Simoens
- Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven Leuven, Belgium
| |
Collapse
|
45
|
Jutkowitz E, Gitlin LN, Pizzi LT. Evaluating willingness-to-pay thresholds for dementia caregiving interventions: application to the tailored activity program. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2010; 13:720-725. [PMID: 20561331 PMCID: PMC5644028 DOI: 10.1111/j.1524-4733.2010.00739.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES The study aims to apply willingness-to-pay (WTP) values derived from the literature to inform decision-makers of the cost-effectiveness of the Tailored Activity Program (TAP), an intervention proven to reduce caregiver burden. METHODS TAP and other caregiver interventions employ an individual perspective and non-quality-adjusted life-year (QALY) outcome measure where the primary objective is to determine caregiver burden from an individual perspective. Therefore, standard cost/QALY thresholds are not appropriate. To identify relevant WTP values, we searched for studies that: 1) were published in the past 5 years and used contingent valuation methodology to identify WTP; 2) assessed WTP for a dementia-related intervention requiring out-of-pocket expenditure; and 3) asked caregivers their WTP for an outcome related to reducing caregiver burden. Three studies were identified utilizing four WTP values. We also assessed potential financial savings that caregivers could achieve from purchasing TAP. To assess the probability of TAP being cost-effective, we built a Monte Carlo simulation to test the four WTP values applied to two TAP outcome measures: reduction in caregiver hours "on duty;" and "doing things." RESULTS For outcome measure "on duty," WTP varied between $1.06/hour and $4.58/hour. For outcome measure "doing things," WTP varied between $2.21/hour and $9.57/hour. Applying the four identified WTP values from the literature to TAP outcomes resulted in TAP cost-effectiveness varying between 50% and 80% for both outcome measures. CONCLUSIONS When WTP data are not collected prospectively or conventional metrics cannot be applied, retrospectively assessing literature-derived WTP may be acceptable for informing decision-makers of potential cost-effectiveness of a proven program. Application of WTP to TAP shows potential cost-effectiveness that can be expected under the tested WTP scenarios.
Collapse
Affiliation(s)
- Eric Jutkowitz
- Doris N. Grandon Center for Health Economics and Outcomes Research, Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | | | | |
Collapse
|
46
|
Lee DW, Neumann PJ, Rizzo JA. Understanding the medical and nonmedical value of diagnostic testing. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2010; 13:310-314. [PMID: 19744295 DOI: 10.1111/j.1524-4733.2009.00597.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To develop a framework for defining the potential value of diagnostic testing, and discuss its implications for the health-care delivery system. METHODS We reviewed the conceptual and empirical literature related to the valuing of diagnostic tests, and used this information to create a framework for characterizing their value. We then made inferences about the impact of this framework on health insurance coverage, health technology assessment, physician-patient relationships, and public health policy. RESULTS Three dimensions can effectively classify the potential value created by diagnostic tests: 1) medical value (impact on treatment decisions); 2) planning value (affect on patients' ability to make better life decisions); and 3) psychic value (how test information affects patients' sense of self). This comprehensive framework for valuing diagnostics suggests that existing health technology assessments may systematically under- or overvalue diagnostics, leading to potentially incorrect conclusions about cost-effectiveness. Further, failure to account for all value dimensions may lead to distorted payments under a value-based health-care system. CONCLUSIONS The potential value created by medical diagnostics incorporates medical value as well as value associated with well-being and planning. Consideration of all three dimensions has important implications for technology assessment and value-based payment.
Collapse
Affiliation(s)
- David W Lee
- GE Healthcare-Health Economics and Outcomes Research, Waukesha, WI 53188-1696, USA.
| | | | | |
Collapse
|
47
|
Coombes BK, Bisset L, Connelly LB, Brooks P, Vicenzino B. Optimising corticosteroid injection for lateral epicondylalgia with the addition of physiotherapy: a protocol for a randomised control trial with placebo comparison. BMC Musculoskelet Disord 2009; 10:76. [PMID: 19552805 PMCID: PMC2707364 DOI: 10.1186/1471-2474-10-76] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 06/24/2009] [Indexed: 12/03/2022] Open
Abstract
Background Corticosteroid injection and physiotherapy are two commonly prescribed interventions for management of lateral epicondylalgia. Corticosteroid injections are the most clinically efficacious in the short term but are associated with high recurrence rates and delayed recovery, while physiotherapy is similar to injections at 6 weeks but with significantly lower recurrence rates. Whilst practitioners frequently recommend combining physiotherapy and injection to overcome harmful effects and improve outcomes, study of the benefits of this combination of treatments is lacking. Clinicians are also faced with the paradox that the powerful anti-inflammatory corticosteroid injections work well, albeit in the short term, for a non-inflammatory condition like lateral epicondylalgia. Surprisingly, these injections have not been rigorously tested against placebo injections. This study primarily addresses both of these issues. Methods A randomised placebo-controlled clinical trial with a 2 × 2 factorial design will evaluate the clinical efficacy, cost-effectiveness and recurrence rates of adding physiotherapy to an injection. In addition, the clinical efficacy and adverse effects of corticosteroid injection beyond that of a placebo saline injection will be studied. 132 participants with a diagnosis of lateral epicondylalgia will be randomly assigned by concealed allocation to one of four treatment groups – corticosteroid injection, saline injection, corticosteroid injection with physiotherapy or saline injection with physiotherapy. Physiotherapy will comprise 8 sessions of elbow manipulation and exercise over an 8 week period. Blinded follow-up assessments will be conducted at baseline, 4, 8, 12, 26 and 52 weeks after randomisation. The primary outcome will be a participant rating of global improvement, from which measures of success and recurrence will be derived. Analyses will be conducted on an intention-to-treat basis using linear mixed and logistic regression models. Healthcare costs will be collected from a societal perspective, and along with willingness-to-pay and quality of life data will facilitate cost-effectiveness and cost-benefit analyses. Conclusion This trial will utilise high quality trial methodologies in accordance with CONSORT guidelines. Findings from this study will assist in the development of evidence based practice recommendations and potentially the optimisation of resource allocation for rehabilitating lateral epicondylalgia. Trial registration Australian New Zealand Clinical Trials Register ACTRN12609000051246
Collapse
Affiliation(s)
- Brooke K Coombes
- The University of Queensland, Division of Physiotherapy, School of Health and Rehabilitation Sciences, St Lucia, QLD, 4072, Australia.
| | | | | | | | | |
Collapse
|
48
|
Chuck A, Adamowicz W, Jacobs P, Ohinmaa A, Dick B, Rashiq S. The willingness to pay for reducing pain and pain-related disability. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2009; 12:498-506. [PMID: 18798809 DOI: 10.1111/j.1524-4733.2008.00457.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES We sought to identify chronic pain patients' preferences for levels of improvement in pain-related morbidity (PRM) by measuring their willingness to pay (WTP) for reducing their pain intensity and pain-related disability. METHODS The study was a cross-sectional nonrandomized design. Participants were recruited from a tertiary multidisciplinary pain center in Canada. A computer-administered discrete-choice experiment was used to explore participants' WTP for various levels of improvement to PRM. Participants chose between two varying combination of treatments that differed in terms of their level of improvement in pain intensity, level of improvement in pain-related disability, and out-of-pocket monthly cost. RESULTS The WTP to completely minimize PRM was $1428 per month. Reduction in pain intensity was valued more highly than functional improvement. For every dollar, an individual was WTP to improve his/her disability to the lowest severity (mild), he/she was WTP approximately $2 to reduce pain intensity to moderate and $3 to reduce pain intensity to mild. The potential return on investment in terms of health improvement gained was $3318 per patient visit per year. CONCLUSION The morbidity associated with chronic pain is worth approximately $1428 for every month in the chronic pain health state. From the patient's perspective, treatment and management strategies that focus on reducing pain intensity would have the greatest impact on improving health-related quality of life. Valuing health improvement in monetary terms allows for direct monetary comparisons between the costs of chronic pain interventions and their associated health returns.
Collapse
|
49
|
Seror V, Ville Y. Prenatal screening for Down syndrome: women's involvement in decision-making and their attitudes to screening. Prenat Diagn 2009; 29:120-8. [DOI: 10.1002/pd.2183] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
50
|
Hu SW, Holt EW, Husni ME, Qureshi AA. Willingness-to-pay stated preferences for 8 health-related quality-of-life domains in psoriatic arthritis: a pilot study. Semin Arthritis Rheum 2008; 39:384-97. [PMID: 19095293 DOI: 10.1016/j.semarthrit.2008.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 09/02/2008] [Accepted: 10/01/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Psoriatic arthritis (PsA) is a seronegative inflammatory arthritis found in up to 5 to 42% of patients with psoriasis. As current instruments do not fully capture health-related quality of life (HR-QOL) in PsA from the patient's perspective, we piloted a novel application of "willingness-to-pay" (WTP) as a Patient Reported Outcome to measure the relative impact of PsA in 8 domains of HR-QOL. METHODS Fifty-nine PsA patients were interviewed on 8 WTP HR-QOL domains (physical, emotional, sleep, work, social, self-care, intimacy, and concentration). Participants were asked to rank the 8 domains of health in order of HR-QOL impact. In each domain, participants were asked whether PsA affected that domain, whether they were willing to pay for a cure in that domain, and the amount they were willing to pay. Median WTP amounts were compared with the proportion of participants affected by and willing to pay in each domain. Responses in US dollars were interpreted as strength of preference rather than absolute monetary values. RESULTS The majority of participants were white (98%), > or =45 years of age (70%), insured (98%), and earned >$65,000/yr (66%). The physical domain was most affected by PsA; intimacy and concentration were ranked lowest. Participants reported a wide range of WTP amounts ($0 to $1,000,000), and median WTP amounts were highest in the physical, work, sleep, and self-care domains. Related domains elicited median WTP amounts that were highly correlated. No significant differences in median WTP amounts were found across ages, genders, and income levels for the different domains. CONCLUSIONS WTP is a novel quantitative patient-perspective measure that is comprehensible and feasible to administer in PsA patients. It represents a unique tool for capturing the complex manifestations of PsA and its impact on the individual, allowing the quantification of specific HR-QOL parameters and providing the potential for comparison across various disease processes in a given individual.
Collapse
|