Evaluating willingness-to-pay thresholds for dementia caregiving interventions: application to the tailored activity...

Area of Science:

• Health Economics
• Caregiver Support Interventions
• Decision Analysis

Background:

• Caregiver burden is a significant issue in dementia care.
• The Tailored Activity Program (TAP) is a proven intervention to reduce caregiver burden.
• Standard cost-effectiveness metrics (e.g., QALYs) are not directly applicable to individual-level caregiver interventions.

Purpose of the Study:

• To assess the cost-effectiveness of the Tailored Activity Program (TAP) using willingness-to-pay (WTP) values from existing literature.
• To inform decision-makers about the economic value of TAP in reducing caregiver burden.

Main Methods:

• Conducted a literature search for willingness-to-pay (WTP) studies using contingent valuation methodology within the last five years.
• Identified four relevant WTP values from three studies assessing caregiver WTP for dementia-related outcomes.
• Utilized a Monte Carlo simulation to evaluate TAP's cost-effectiveness probability based on identified WTP values and two outcome measures: reduction in caregiver hours 'on duty' and 'doing things'.

Main Results:

• Willingness-to-pay (WTP) values for reducing caregiver burden ranged from $1.06/hour to $4.58/hour for 'on duty' hours and $2.21/hour to $9.57/hour for 'doing things'.
• Applying these WTP values indicated that TAP's cost-effectiveness probability ranged between 50% and 80% for both outcome measures.

Conclusions:

• Retrospectively applying literature-derived willingness-to-pay (WTP) values can be a viable method for assessing the cost-effectiveness of interventions when prospective data are unavailable or standard metrics are inappropriate.
• The Tailored Activity Program (TAP) demonstrates potential cost-effectiveness, supporting its value for caregivers under the evaluated WTP scenarios.