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Parents' willingness to pay for biologic treatments in juvenile idiopathic arthritis
Heather F Burnett1, Wendy J Ungar2, Dean A Regier3
1Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Parents value treatments that improve daily activities and reduce pain for children with juvenile idiopathic arthritis (JIA). They show a higher willingness to pay for more effective biologic disease-modifying antirheumatic drugs (DMARDs).
Area of Science:
- Pediatric Rheumatology
- Health Economics
- Patient-Reported Outcomes
Background:
- Biologic therapies are standard for severe juvenile idiopathic arthritis (JIA).
- Access to these treatments is often limited by drug coverage issues.
- This study addresses the financial preferences of parents regarding JIA treatments.
Purpose of the Study:
- To evaluate parents' willingness to pay (WTP) for biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs) for JIA.
- To understand the monetary value parents place on specific treatment attributes.
- To inform healthcare decision-making by incorporating family preferences.
Main Methods:
- Discrete choice experiment to derive utility weights for treatment characteristics.
- Conditional logit regression to estimate utilities for attribute levels.
- Bootstrapping used for calculating 95% confidence intervals for WTP estimates.
Main Results:
- Parents prioritized improved daily activity participation and pain relief.
- Elimination of treatment side effects was also highly valued.
- Parents were willing to pay an additional $2080 for more effective biologic DMARDs compared to nonbiologic options.
Conclusions:
- Parents' WTP reflects a preference for JIA treatments that minimize pain and side effects while enhancing daily functioning.
- Monetary valuation of utility provides insights into family-valued aspects of JIA drug treatments.
- These findings offer a comprehensive perspective for decision-makers beyond safety and efficacy data.
Background:
Biologic therapies are considered the standard of care for children with the most severe forms of juvenile idiopathic arthritis (JIA). Inconsistent and inadequate drug coverage, however, prevents many children from receiving timely and equitable access to the best treatment.
Objective:
The objective of this study was to evaluate parents' willingness to pay (WTP) for biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs) used to treat JIA.
Methods:
Utility weights from a discrete choice experiment were used to estimate the WTP for treatment characteristics including child-reported pain, participation in daily activities, side effects, days missed from school, drug treatment, and cost. Conditional logit regression was used to estimate utilities for each attribute level, and expected compensating variation was used to estimate the WTP. Bootstrapping was used to generate 95% confidence intervals for all WTP estimates.
Results:
Parents had the highest marginal WTP for improved participation in daily activities and pain relief followed by the elimination of side effects of treatment. Parents were willing to pay $2080 (95% confidence interval $698-$4065) more for biologic DMARDs than for nonbiologic DMARDs if the biologic DMARD was more effective.
Conclusions:
Parents' WTP indicates their preference for treatments that reduce pain and improve daily functioning without side effects by estimating the monetary equivalent of utility for drug treatments in JIA. In addition to evidence of safety and efficacy, assessments of parents' preferences provide a broader perspective to decision makers by helping them understand the aspects of drug treatments in JIA that are most valued by families.
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