Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, Manchester, UK.
Br J Ophthalmol. 2013 Aug;97(8):1051-6. doi: 10.1136/bjophthalmol-2012-303020. Epub 2013 Jun 6.
Technological advances present an opportunity for more people with, or at risk of, developing retinitis pigmentosa (RP) to be offered genetic testing. Valuation of these tests using current evaluative frameworks is problematic since benefits may be derived from diagnostic information rather than improvements in health. This pilot study aimed to explore if contingent valuation method (CVM) can be used to value the benefits of genetic testing for RP.
CVM was used to elicit willingness-to-pay (WTP) values for (1) genetic counselling and (2) genetic counselling with genetic testing. Telephone and face-to-face interviews with a purposive sample of individuals with (n=25), and without (n=27), prior experience of RP were used to explore the feasibility and validity of CVM in this context.
Faced with a hypothetical scenario, the majority of participants stated that they would seek genetic counselling and testing in the context of RP. Between participant groups, respondents offered similar justifications for stated WTP values. Overall stated WTP was higher for genetic counselling plus testing (median=£524.00) compared with counselling alone (median=£224.50). Between-group differences in stated WTP were statistically significant; participants with prior knowledge of the condition were willing to pay more for genetic ophthalmology services.
Participants were able to attach a monetary value to the perceived potential benefit that genetic testing offered regardless of prior experience of the condition. This exploratory work represents an important step towards evaluating these services using formal cost-benefit analysis.
技术进步为更多患有或有罹患视网膜色素变性（RP）风险的人提供了进行基因检测的机会。由于这些测试的收益可能来自诊断信息，而不是健康状况的改善，因此使用当前评估框架来评估这些测试存在问题。这项初步研究旨在探讨条件价值评估法（CVM）是否可用于评估 RP 基因检测的收益。
采用 CVM 来获取（1）基因咨询和（2）基因咨询加基因检测的意愿支付（WTP）值。对有（n=25）和无（n=27）RP 既往经历的个体进行了有针对性的电话和面对面访谈，以探讨在这种情况下 CVM 的可行性和有效性。
在面临假设情况下，大多数参与者表示，他们将在 RP 背景下寻求基因咨询和检测。在参与者群体之间，受访者对其 WTP 值提出了类似的理由。与单独咨询相比，基因咨询加检测的总体 WTP 更高（中位数=£524.00）。有条件知识的参与者在 WTP 方面的组间差异具有统计学意义；他们更愿意为基因眼科服务支付更多费用。
无论患者对该疾病的既往经验如何，参与者都能够为基因检测提供的潜在收益赋予货币价值。这项探索性工作代表着使用正式成本效益分析评估这些服务的重要一步。
