Willingness to pay and accept risks to cure chronic disease

Area of Science:

• Health Economics
• Rheumatology
• Quality of Life Research

Background:

• Traditional disease burden measurements often overlook quality of life impacts, focusing primarily on economic outputs.
• Quantifying the true burden of illness necessitates understanding patient willingness to pay (WTP) or accept risk (MAR) to avoid or cure disease.
• Existing WTP and MAR methods face challenges with low response rates and participant comprehension, questioning their practicality.

Purpose of the Study:

• To assess the feasibility of using WTP and MAR questions in patients with rheumatoid arthritis.
• To determine the extent of income patients would pay and the mortality risk they would accept for a cure.
• To explore associations between WTP/MAR and specific disease aspects like daily living impairment and pain.

Main Methods:

• A study involving 247 rheumatoid arthritis patients interviewed by trained professionals.
• Patients were asked about their maximum acceptable risk (MAR) of immediate death and willingness to pay (WTP) for a hypothetical cure.
• Data collected included WTP as a percentage of household income and MAR as a percentage chance of death.

Main Results:

• High response rates were achieved: 98% provided MAR estimates (average 27% chance of immediate death) and 84% provided plausible WTP responses (average 22% of household income).
• Impairment in daily activities was strongly linked to WTP.
• Measured pain was the primary factor associated with MAR.

Conclusions:

• The study demonstrates the feasibility of using WTP and MAR methods in clinical populations, achieving high response rates.
• WTP and MAR are influenced by specific patient circumstances, such as daily functioning and pain levels.
• These findings support the systematic inclusion of personal circumstances when evaluating disease burden and treatment preferences.