Willingness-to-pay and Time Trade-off: The Burden of Disease in Patients with Benign Hyperpigmentation.

We assessed willingness-to-pay (WTP) and time trade-off (TTO) as methods to quantify the disease burden of benign hyperpigmentation. This was a cross-sectional pilot study that included 85 adults. A paper survey was used to collect demographic and health utility information; an accompanying dermatological exam assessed disease severity. This was a single-site study performed at an urban dermatology clinic. Adults 18 years of age or older who spoke English, Spanish, or Portuguese were included. Utility measures included WTP, TTO, and time spent concealing the condition; correlation with quality of life was also assessed. Mean WTP for 25-percent improvement (WTP25) of the skin condition was $38.95; for a 50-percent improvement (WTP50), $83.18. Participants were willing to give up 1.4 hours per day to receive a therapy that would completely cure their condition. The average proportion of monthly income that participants were willing to spend on a therapy that could cure their condition was 13.3 percent. Daily concealment time was, on average, 20.8 minutes, which correlated with a worsened quality of life. Disease burden was high, overall, for benign hyperpigmentation conditions. Health utilities offer a patient-centered method of assessing impact on quality of life.