Patient preferences and willingness to pay for innovations in intermittent self-catheters

Abstract

Binny Pinder,1 Andrew J Lloyd,1 Beenish Nafees,1 Eric P Elkin,2 Jerome Marley3 1ICON plc, Oxford, UK; 2ICON plc, San Francisco, CA, USA; 3School of Nursing, University of Ulster, Newtownabbey, UK Background: Intermittent catheterization is the gold standard for bladder management in Europe in people with spinal cord injuries. The aim of the present study was to identify and investigate individuals’ preferences regarding intermittent self-catheterization (ISC) devices and furthermore investigate the willingness to pay for attributes in ISC devices in the UK, France, and the Netherlands.Methods: A discrete choice experiment survey was conducted to evaluate the patients’ perceived value of catheter features. Attributes were selected based upon a literature review of the most important characteristics of catheters and the survey was developed and validated with input from patients and medical experts. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log) odds ratios of preference for attributes. Willingness to pay was estimated for all levels of the attributes.Results: Two-hundred and eighty-three participants completed the questionnaire and were included in data analysis. Risk of infection had the highest odds ratios as preferred important attribute for all three countries followed by ease of insertion. “Pre-coated catheters” was found to be valued as the most preferred coating technology across all countries. Out of pocket cost was a significant influence on patients’ choice.Conclusion: Users of ISC perceive the value of convenience (size of catheter), ease of insertion, and reduced risk of infection as the most important features attached to an intermittent catheter. These results are applicable both for the “classic” ISC user as well as for another broad group of catheter dependent individuals. Keywords: self-intermittent catheterization, utility, discrete choice experiment, perceived value