Department of Clinical Epidemiology and Biostatistics, McMaster University DTC, 50 Main Street East, 3rd Floor, Hamilton, ON, L8N 1E9, Canada,
Patient. 2013;6(3):161-8. doi: 10.1007/s40271-013-0014-3.
Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognition and function.
The aim of this article is to assess whether persons with AD would support out-of-pocket payment for an AD medication; to elicit the monthly dollar amounts they would pay.
We recruited persons with mild or moderate AD (n = 216) from nine clinics across Canada. During one-on-one interviews, we presented our sample with four scenarios describing a medication that either treated disease symptoms or modified the course of AD; each version of the medication was alternatively presented as having a 0 % or 30 % chance of adverse effects. For each scenario, participants indicated whether they would support paying out-of-pocket for the medication (yes/no). Affirmative responses were followed with questions asking participants whether they would pay $75, $150, or $225 (Canadian dollars) per month.
Levels of support ('yes' responses) ranged from 57 % to 83 % and mean willingness-to-pay ranged from $98 to $137, depending on scenario. Participants were more likely to provide affirmative responses and higher willingness-to-pay amounts when the medication modified disease or had a 0 % chance of adverse effects. Age was inversely associated with support in three scenarios and willingness-to-pay amounts in all four scenarios. Positive associations between post-secondary education and willingness-to-pay amounts were found in three scenarios.
Persons with mild or moderate AD were often willing to pay out-of-pocket for AD medications. However, the mean maximum willingness-to-pay ($137) for the optimal medication scenario was lower than the average monthly cost of existing AD medications.
阿尔茨海默病（AD）是一种神经退行性疾病，其特征是认知和功能逐渐下降。
本文旨在评估 AD 患者是否愿意自费购买 AD 药物；并了解他们愿意支付的月金额。
我们从加拿大的 9 个诊所招募了轻度或中度 AD 患者（n = 216）。在一对一的访谈中，我们向患者展示了四个描述一种药物的情景，该药物要么治疗疾病症状，要么改变 AD 的病程；每个版本的药物分别表示有 0%或 30%的不良反应发生几率。对于每个情景，参与者都要表明他们是否愿意自费购买该药物（是/否）。对肯定的回答，我们接着询问他们是否愿意每月支付 75、150 或 225 加元（加元）。
支持率（“是”的回答）从 57%到 83%不等，根据情景的不同，每月愿意支付的金额从 98 加元到 137 加元不等。当药物改变疾病或无不良反应发生几率时，患者更有可能提供肯定的回答和更高的支付意愿。在三个情景中，年龄与支持率呈负相关，而在所有四个情景中，年龄与支付意愿金额呈负相关。在三个情景中，都发现了接受过高等教育与支付意愿金额之间的正相关关系。
轻度或中度 AD 患者通常愿意自费购买 AD 药物。然而，最优药物情景下的平均最高支付意愿（137 加元）低于现有 AD 药物的平均月费用。
