An assessment of the burden of migraine using the willingness to pay model
An assessment of the burden of migraine using the willingness to pay model
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DOI：
10.1111/j.1468-2982.2005.00797.x
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发表时间：
2005-02-01
期刊：
影响因子：
4.9
通讯作者：
Stewart, WF
中科院分区：
文献类型：
--
作者：
Hamelsky, SW;Lipton, RB;Stewart, WF
支付意愿方法衡量治疗偏好，也从经济角度衡量疾病负担。我们根据不同的治疗效果和偏头痛患者的特征，使用条件评估方法来衡量偏头痛患者对其最严重头痛发作的急性药物的支付意愿（WTP）。受试者是从基于人群的偏头痛患者数据库中识别出来的，这些数据库之前是通过随机数字拨号招募的。电话访谈（n = 1428）用于收集人口统计和头痛特征。符合国际头痛协会有或无先兆偏头痛标准并满足基于电话访谈的其他纳入标准的受试者 (n = 312) 被邀请参加邮寄问卷研究。调查问卷被邮寄给同意参与的 310 名受试者，并返回 201 份（65%）调查问卷。该调查包括有关受访者的人口统计、偏头痛特征和心理倾向的问题。探讨了采用 14 种不同的假设治疗方案进行急性偏头痛治疗的 WTP。调查的答复者和未答复者总体上相似。新设计的WTP问卷具有较高的内部一致性（Cronbach's alpha 0.90）和重测信度（Spearman's Correlation Factors 0.71-0.77）。研究对象愿意支付中位价格 5 美元的偏头痛治疗，这种治疗可在 30 分钟内完全缓解，并且 100% 有效，没有副作用，也没有头痛复发。当治疗属性偏离这一理想值时，中位支付意愿会下降。例如，2 小时内完全缓解的支付意愿中位数下降至 1 美元，4 小时内完全缓解的支付意愿中位数下降至 0.25 美元。所有药物属性都强烈影响 WTP，有几个变量预测 WTP，包括当前的药物支付、MIDAS（III 级）和长期头痛的患者。使用更多应对技能的受试者不太愿意付费。患者人口统计数据和偏头痛严重程度可预测 WTP，但治疗属性也很重要。随着治疗的改善，偏头痛药物的支付意愿可能会增加。
Willingness to pay methods measure treatment preferences and also measure the burden of illness in economic terms. We used a contingent valuation method to measure migraine sufferers' willingness to pay (WTP) for acute medication for their most severe headache attacks, based on various profiles of treatment benefits and the characteristics of the migraine sufferer. Subjects were identified from a population-based database of migraine sufferers, previously recruited by random digit dialling. Telephone interviews (n = 1428) were used to gather demographic and headache characteristics. Subjects who met the International Headache Society criteria for migraine with or without aura and satisfied the other inclusion criteria based on telephone interview (n = 312) were invited to participate in a mailed questionnaire study. The questionnaire was mailed to the 310 subjects who agreed to participate and 201 (65%) surveys were returned. The survey included questions on the demographics, the migraine characteristics, and the psychological disposition of the respondents. WTP for an acute migraine treatment with 14 different hypothetical treatment profiles was explored. Responders and nonresponders to the survey were generally similar. The newly designed WTP questionnaire had high internal consistency (Cronbach's alpha 0.90) and test-retest reliability (Spearman's corrleation coefficients 0.71-0.77). Study subjects were willing to pay a median price of $5 for a migraine treatment that provided complete relief in 30 min and worked 100% of the time, with no side-effects and no headache recurrence. Median WTP decreased as treatment attributes deviated from this ideal. For example, WTP declined to a median of $1 for complete relief in 2 h and to $0.25 for complete relief in 4 h. All of the medication attributes powerfully influenced WTP, Several variables predicted WTP including current payment for medication, MIDAS (Grade III), and those with headaches of long duration. Subjects who employed a greater number of coping skills were less willing to pay. Patient demographics and migraine severity predict WTP, but treatment attributes were also important. As treatment improves, WTP for migraine medications is likely to increase.