Survey amongst health care professionals—Willingness to pay for novel therapies

Abstract

6138 Background: Singapore’s state sponsored healthcare system provides subsidies for “standard” oncology drugs (patients co-pay). Patients pay full cost for access to newer therapies prior to Government assessment for subsidy eligibility. Methods: A questionnaire-based study was performed to determine willingness to pay (WTP) for newer anti-cancer therapies (Herceptin, Avastin, Iressa). In addition to absolute dollar cost, patients were asked to tradeoff material goods (cars, house, electronic goods) to purchase such drugs. Face to face interviews were conducted amongst HCP by a single interviewer at Singapore National Cancer Centre from 24 Nov to 16 Dec 06. The questionnaire provided didactic information of such drug benefits in either the appropriate adjuvant or palliative setting. Results: Population: 70 out of 76 HCP responded to the survey—36 doctors (radiation and medical oncologists) and 34 oncology nurses. 60% were female, 61% married and 48% had dependent children. 71% supported parents financially. Median length of practice for doctors(drs) was 10 years (range 2 to 35) and 9 years (range 2 to 29) for nurses(nrs). Median income bracket was USD 3000–5000/mth and USD 1200–3000/ mth respectively. Findings: 69% of respondents reported WTP for herceptin (97% for drs and 38% of nrs). Although drs were most able to afford herceptin, they also demonstrated the highest willingness to trade off material goods to pay for treatment. 57% would sell their houses and 71% sell their cars to pay for herceptin. Almost the entire cohort reported willingness to forego discretionary spending on restaurant dining, clothes and electronics. Only 20% of respondents were WTP for palliative avastin for advanced colon cancer. 53% were willing to pay for a trial of Iressa (for advanced non-small cell lung cancer). If response was favorable, 68% were willing to sell their house to pay to continue palliative treatment. This survey must be interpreted in the context of a relatively affluent Asian population. Conclusions: Government healthcare programs worldwide will find increasingly difficulty paying for expensive novel therapies. At an individual level, respondents demonstrate a high WTP and forego substantial material goods for access to such novel agents. No significant financial relationships to disclose.