PIN20 Study on Disease Treatment Preference and Willingness Payment in Hepatitis C Patients

Abstract

Hepatitis C has become a global public health problem, and the long-term complications have brought great economic burden on patients. In China, the standard of care(SOC) for chronic hepatitis C is pegylated interferon plus ribavirin, which is not very effective and associated with relative high risk of side effects. The arise of direct-acting antivirals (DAAs) has dramatically improved the effectiveness and reduced the incidence of side effects, but they are expensive than SOC at the same time. To study the disease treatment preference and willingness payment for different treatment regimens in Hepatitis C patients using discrete choice experiment(DCE), so as to provide reference for improving the participation of patients in decision-making. Eight attributes related to Hepatitis C were determined by literature review and pre-survey. The probability of occurrence and severity were considered at the same time for the side effects. The orthogonal experimental design was used to generate 32 combinations to form DCE questionnaire. The survey was conducted in Tianjin in December 2018. Effects coding and random parameter logit model was used for data analysis. A total of 111 patients completed the questionnaire, of which 36.04% were male. The preference weight for different attributes was ranked as following: sustained virological response(SVR), nausea/vomiting, rash, insomnia, number of interferon injections, weeks of treatment, tiredness/fatigue and the relative weight was 10.00, 2.12, 1.32, 0.69, 0.32, 0.23 and 0.17, respectively. In terms of willingness payment, patients are willing to pay RMB 33,873 per course of treatment to achieve the highest SVR. From the perspective of patients, efficacy is the most essential criterion to be considered. Side effects and modes of administration also play a certain role in the treatment choice of patients. Furthermore, patients have different evaluations on the probability and severity for the same side effects.