Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg, Germany.
Department of Dermatology, Eberhard-Karls University of Tübingen, Tübingen, Germany.
PLoS One. 2018 May 24;13(5):e0197780. doi: 10.1371/journal.pone.0197780. eCollection 2018.
Malignant melanoma is potentially life-threatening but in most cases curable if detected early. Willingness to pay (WTP) is a preference-based construct that reflects burden of disease by assessment of the monetary value for a hypothetical cure from disease. Since WTP (directly as total amount of money) has not been assessed so far in patients with low risk melanoma, it was interesting to gain insights in this patient population and then, in a second step, compare it directly with the WTP of their treating dermato-oncologists. WTP was assessed in 125 patients with low-risk melanoma and additionally in 105 treating physicians, asking for the one-time and continuous payments they would be willing to make for a sustainable cure, both as absolute sums and as percentages of monthly income. The median WTP based on one-time payment was €10,000 for patients and €100,000 for physicians; relative numbers were 100% versus 300% of monthly income. For continuous monthly payments, WTP was €500 for patients and €1000 for physicians, relative numbers 25% and 50% of income, respectively. Even after controlling for income differences, there was a significantly higher WTP in physicians for all four questions. Compared to patients with chronic skin diseases such as vitiligo, rosacea, atopic eczema and psoriasis, patients with low-risk melanoma showed a significantly higher WTP. Our data suggest that there is a relevant burden of disease even in patients with low-risk tumors. Higher WTP of physicians underlines the prevalence of differences in disease perception.
恶性黑素瘤具有潜在的致命风险,但如果早期发现,大多数情况下是可以治愈的。意愿支付(Willingness to pay,WTP)是一种基于偏好的构建,通过评估疾病假设治愈的货币价值来反映疾病负担。由于迄今为止尚未在低危黑素瘤患者中评估 WTP(直接作为总金额),因此了解这一患者群体的情况并在第二步中直接将其与他们的治疗皮肤科肿瘤学家的 WTP 进行比较是很有趣的。评估了 125 名低危黑素瘤患者和 105 名治疗医生的 WTP,询问他们愿意为可持续治愈支付的一次性和持续付款,包括绝对金额和作为月收入的百分比。基于一次性付款的 WTP 中位数为患者 10,000 欧元,医生 100,000 欧元;相对数字分别为月收入的 100%和 300%。对于连续每月付款,患者的 WTP 为 500 欧元,医生为 1000 欧元,相对数字分别为收入的 25%和 50%。即使在控制收入差异后,所有四个问题的医生 WTP 仍然明显更高。与患有慢性皮肤病(如白癜风、酒渣鼻、特应性皮炎和银屑病)的患者相比,低危黑素瘤患者的 WTP 明显更高。我们的数据表明,即使在低危肿瘤患者中,也存在相关的疾病负担。医生的 WTP 较高强调了疾病认知差异的普遍性。