Skip to main content
Free access
Research Article
16 January 2019

Willingness to pay for medical treatments in chronic diseases: a multicountry survey of patients and physicians

Abstract

Aim: The objective was to investigate factors influencing patients’ willingness to pay (WTP) and physician’s views on the cost of therapy for two contrasted chronic diseases, chronic heart failure and psoriasis. Methods: A cross-sectional survey was conducted in ten developing countries, using a stated WTP contingent valuation method. Multivariate analyses were performed by linear regression. Results: Independent factors influencing patient WTP were income (+0.04 $PPP [purchasing power parity] in WTP per $PPP in monthly income; p < 0.001) and purchase of branded treatment for chronic heart failure therapy, and income, out-of-pocket treatment costs but also education level higher than secondary school (+115 $PPP in WTP comparatively to patients with none/primary school level; p = 0.008) for psoriasis therapy, suggesting the influence of sociopsychological factors in this disease. Conclusion: Disease-specific factors may affect WTP for treatment that should be accounted for to support effective public health programs in developing countries.

Formats available

You can view the full content in the following formats:

References

Papers of special note have been highlighted as: • of interest
1.
Tambor M, Pavlova M, Rechel B, Golinowska S, Sowada C, Groot W. Willingness to pay for publicly financed health care services in Central and Eastern Europe: evidence from six countries based on a contingent valuation method. Soc. Sci. Med. 116, 193–201 (2014).
2.
Breidert C, Hahsler M, Reutterer T. A review of methods for measuring willingness-to-pay. Innov. Market. 2(4), 8–32 (2006).
• Provides key background on mehods for measuring willingness to pay.
3.
Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated preference studies reporting public preferences for healthcare priority setting. Patient 7(4), 365–386 (2014).
4.
Lin PJ, Cangelosi MJ, Lee DW, Neumann PJ. Willingness to pay for diagnostic technologies: a review of the contingent valuation literature. Value Health 16(5), 797–805 (2013).
5.
Deogaonkar R, Hutubessy R, Van Der Putten I, Evers S, Jit M. Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries. BMC Public Health 12, 878 (2012).
6.
Whitty JA, Stewart S, Carrington MJ et al. Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial. PLoS ONE 8(3), e58347 (2013).
7.
Delfino M, Jr., Holt EW, Taylor CR, Wittenberg E, Qureshi AA. Willingness-to-pay stated preferences for 8 health-related quality-of-life domains in psoriasis: a pilot study. J. Am. Acad. Derm. 59(3), 439–447 (2008).
• Provides key information on quality of life and preferences of patients with psoriasis.
8.
Ademi Z, Pasupathi K, Liew D. Cost–effectiveness of eplerenone compared to usual care in patients with chronic heart failure and NYHA class II symptoms, an Australian perspective. Medicine 95(18), e3531 (2016).
9.
Beikert FC, Langenbruch AK, Radtke MA, Kornek T, Purwins S, Augustin M. Willingness to pay and quality of life in patients with atopic dermatitis. Arch. Dermatolog. Res. 306(3), 279–286 (2014).
10.
Bridges JF. Stated preference methods in health care evaluation: an emerging methodological paradigm in health economics. Ap. Health Econ. Health Pol. 2(4), 213–224 (2003).
• Other overview of stated preference techniques in health economics.
11.
Foreit JR, Foreit KG. The reliability and validity of willingness to pay surveys for reproductive health pricing decisions in developing countries. Health Policy 63(1), 37–47 (2003).
12.
Fendrick AM, Chernew ME. Value-based insurance design: aligning incentives to bridge the divide between quality improvement and cost containment. Am. J. Manag. Care 12(Spec no.), SP5–SP10 (2006).
13.
Braithwaite R, Rosen AB. Linking cost sharing to value: an unrivaled yet unrealized public health opportunity. Ann. Intern. Med. 146(8), 602–605 (2007).
14.
Radtke MA, Schafer I, Gajur A, Langenbruch A, Augustin M. Willingness-to-pay and quality of life in patients with vitiligo. Brit. J. Dermatol. 161(1), 134–139 (2009).
15.
Greenberg D, Hammerman A, Vinker S, Shani A, Yermiahu Y, Neumann PJ. Which is more valuable, longer survival or better quality of life? Israeli oncologists' and family physicians’ attitudes toward the relative value of new cancer and congestive heart failure interventions. Value Health 16(5), 842–847 (2013).
• Provides key information on quality of life and preferences of patients with chronic health failure.
16.
Fonta WM, Ichoku HE, Kabubo-Mariara J. The effect of protest zeros on estimates of willingness to pay in healthcare contingent valuation analysis. Ap. Health Econ. Health Pol. 8(4), 225–237 (2010).
17.
Murphy JJ, Allen PG, Stevens TH, Weatherhead D. A Meta-analysis of hypothetical bias in stated preference valuation. Environ. Resource Econ. 30(3), 313–325 (2005).