Willingness to pay for a new drug delivery in Parkinson patients

Abstract

Johan Lökk,1,2 Sara Olofsson,3 Ulf Persson3 1Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; 2Geriatric Department, Karolinska University Hospital, Stockholm, Sweden; 3The Swedish Institute for Health Economics, Institute for Health Economics (IHE), Lund, Sweden Objective: The Swedish reimbursement system operates a system where prices are set based on the expected value to the consumer. This value can be measured using willingness to pay (WTP). Aim: To assess Parkinson's disease (PD) patients' WTP for newly developed microtablets of levodopa in combination with a drug-delivering electronic device (M/E) compared to standard treatment with levodopa in combination with the COMT (catechol-O-methyl transferase)-inhibitor entacapone (L/e). Method: A total of 2,000 randomly included PD patients had a postal questionnaire covering demographics, disease-specific issues, views on medication and WTP in different hypothetical scenarios. The first scenario was M/E with no change in effects or side effects; the second scenario was M/E with same effect and less side effects; and the third scenario was M/E with improved effect and less side effects. These scenarios were coupled to different costs to choose from. Results: A total of 999 patients (50%) responded, mean age of 71 years and a mean PD duration of 9 years. Of all respondents, 50% preferred M/E before L/e in scenario one with increasing preference to scenario three. The average monthly WTP among all respondents in scenario one was SEK 230 and SEK 226 in L/e, both with an almost longitudinal doubling up to scenario three. Duration of PD-related symptoms, high education, and high medication intake implied a higher WTP in all scenarios in contrast to age, sex, and extra doses of levodopa. Conclusion: WTP for M/E increased gradually with high medication intake and education as well as with expected increased reduction of PD symptoms. Keywords: Parkinson's disease, levodopa, microtablets, WTP