Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Willingness to pay (WTP) is a technique used for valuing health benefits and individual preferences. Brazil’s national public health system (Sistema Único de Saúde) grants the population access to costly and effective drugs for the management of rheumatoid arthritis (RA). The aim of this study was to establish WTP valuations for highly effective drug treatments in Brazilian RA patients.
Methods: This cross-sectional multicenter study enrolled adult RA patients (ACR 1987 or ACR/EULAR 2010 criteria) from rheumatology outpatient clinics of the Brazilian public health system. Consecutive patients were asked to reveal the maximum monetary value they would be willing to pay, on a monthly basis, for a hypothetical new intravenous drug offering a 90% improvement in their general health, thus a highly effective drug. Two WTP elicitation tools were used: a payment scale and an open-ended format. Demographic, social and clinical data were gathered from each subject. Disease activity was estimated by DAS28 score and physical function was assessed by HAQ-DI. Descriptive statistics were calculated.
Results: From April 2014 to May 2015, 688 patients (87% female) were assessed in eight Brazilian centers from all over the country. Mean disease duration was 12.7 (8.7) years; mean DAS28 = 3.5 (1.4); mean HAQ-DI = 1.23 (0.8). Subjects had a median of 6 (0 to 21) years of schooling and median household income of US$ 610.3 (0 to 7,909.9) per month. Median WTP values were US$ 22.9 (Q1=11.5; Q3=91.6) on payment scale, and US$ 38.2 (Q1=22.9; Q3=76.3) on open-ended format. On payment scale, 4.2% (28/665) of the respondents assigned zero values for WTP. Overall, 12.4% (83/688) of the subjects added commentaries expressing no willingness to pay at all, regardless of the value (if any) assigned to the elicitation tools. The ratio between median WTP value (open-ended format) and median household income was 6.3%.
Conclusion: This study set WTP valuations of highly effective intravenous drug treatments for chronic, moderately active RA, in outpatient clinics of the Brazilian public health system. The typical population attending to those clinics had low educational and income profile, and had free access to health resources, including medicines, seldom expecting to pay directly for their treatment. The stated WTP values were low, in face of the well known high costs of treating RA patients. Nonetheless, as a proportion of household income, WTP values were in line with the average expenditure of Brazilian families with health resources.
To cite this abstract in AMA style:Albuquerque C, Haddad P, Fernandes V, Marques C, Fialho S, Kakehasi A, Jennings F, Brenol C, Mota LMH, Castelar-Pinheiro G, Duarte A, Giroto I, C. Pinto MR, Toni M, Mendes Abreu M, B. Ferraz M. Willingness to Pay for Highly Effective Drug Treatments in Brazilian Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/willingness-to-pay-for-highly-effective-drug-treatments-in-brazilian-rheumatoid-arthritis-patients/. Accessed February 18, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/willingness-to-pay-for-highly-effective-drug-treatments-in-brazilian-rheumatoid-arthritis-patients/