Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan and Suao Branch, Ilan, Taiwan, ROC.
J Chin Med Assoc. 2021 Apr 1;84(4):446-452. doi: 10.1097/JCMA.0000000000000504.
Alzheimer's disease (AD) exerts significant financial expenses on caregivers, and knowledge of caregivers' support for out-of-pocket payment is of great importance for policymaking on the insurance coverage of future AD medication in Taiwan. We aimed to investigate caregivers' willingness to pay (WTP) for a hypothetical curative AD medication and the effect of different factors on the amount of WTP.
Informal caregivers of patients with AD and informants of patients with amnestic mild cognitive impairment (MCI) were included. An iterative bidding game technique, followed by a dichotomous choice question and a final open-ended question were used to elicit caregivers' maximum WTP. The correlations between the WTP and characteristics of caregiver and patient were analyzed, including sex, educational level, severity of dementia, neuropsychiatric symptoms assessed by Neuropsychiatric Inventory, time needed to support patients assessed by Caregiver Activity Survey, and caregivers' monthly income.
A total of 1134 informal caregivers of patients with AD or MCI were included. Caregivers of patients with AD were willing to pay for a curative AD medication, and their maximum WTP value was higher than informants of MCI patients. Among patients with AD and patients with MCI, caregivers' monthly income was positively correlated with WTP. Apathy subsyndrome was the only factor correlated with percentage of WTP in caregiver's income in the MCI group.
Support for out-of-pocket WTP for a hypothetical curative AD medication was significantly related to caregiver's income.
阿尔茨海默病（AD）给照料者带来了巨大的经济负担，了解照料者对自付费用的支持对于台湾未来 AD 药物保险覆盖范围的政策制定具有重要意义。我们旨在调查照料者对假设的治疗 AD 药物的支付意愿（WTP）以及不同因素对 WTP 金额的影响。
纳入 AD 患者的非正式照料者和遗忘型轻度认知障碍（MCI）患者的知情人。采用迭代投标游戏技术，随后进行二项选择问题和最终开放式问题，以得出照料者的最大 WTP。分析了 WTP 与照料者和患者特征之间的相关性，包括性别、教育水平、痴呆严重程度、神经精神症状评估的神经精神疾病问卷、照顾者活动调查评估的支持患者所需时间，以及照料者的月收入。
共纳入 1134 名 AD 或 MCI 患者的非正式照料者。AD 患者的照料者愿意为治疗 AD 的药物付费，他们的最大 WTP 值高于 MCI 患者的知情人。在 AD 患者和 MCI 患者中，照料者的月收入与 WTP 呈正相关。淡漠综合征是 MCI 组中与照料者收入中 WTP 百分比相关的唯一因素。
对假设的治疗 AD 药物的自付 WTP 的支持与照料者的收入显著相关。
