Assessing willingness to pay for HLA-B*58:01 genetic testing before allopurinol initiation and its potential impact on future health policy, Thailand

This study aimed to assessed patients with gout regarding their willingness to pay (WTP) for Human Leukocyte Antigen type-B* 58:01 (HLA-B*58:01) genetic testing before starting allopurinol and identified factors influencing WTP, including the cost of alternative urate-lowering therapy (ULT). A cross-sectional study was conducted using a validated, open-ended questionnaire. Participants over 20 years old were recruited from Naresuan University Hospital and three affiliated sub-district health-promoting hospitals. The majority were male, with a mean age of 64.52 ± 12.82 years. Most participants (86.00%) expressed WTP for the genetic testing, with high cost (62.86%) and insufficient income (25.71%) being the main reasons for un-WTP. Most could afford a median of THB 500 (USD 14.37). WTP for febuxostat, sulfinpyrazone, and benzbromarone was 68.00%, 67.60%, and 71.60%, respectively. Participants were willing to pay a median of THB 1000 (USD 28.74) for febuxostat or sulfinpyrazone, and THB 285 (USD 8.19) for benzbromarone. Multiple logistic regression showed that patient's income and health insurance type particularly non-Civil Servant Medical Benefit Scheme coverage were significantly associated with WTP for the genetic testing. Overall, most participants were willing to pay THB 500 (USD 14.36) for the genetic testing. The study provides insights for policymakers in pricing the genetic testing and ULT coverage in Thailand.