Willingness to pay for a cure of low-risk melanoma patients in Germany

• Published in: PloS one 2018-05, Vol.13 (5), p.e0197780-e0197780
• Main Authors: Augustin, Matthias, Blome, Christine, Forschner, Andrea, Gutzmer, Ralf, Hauschild, Axel, Heinzerling, Lucie, Livingstone, Elisabeth, Loquai, Carmen, Schadendorf, Dirk, Utikal, Jochen, Wagner, Tobias, Wilden, Sophia, Kähler, Katharina C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atopy; Breast cancer; Cancer therapies; Care and treatment; Cost of Illness; Dermatology; Eczema; Female; Germany; Health care costs; Health risks; Health services; Hospitals; Humans; Income; Male; Medical diagnosis; Medical personnel; Medical prognosis; Medical research; Medicine and Health Sciences; Melanoma; Melanoma - economics; Melanoma - pathology; Melanoma - psychology; Melanoma - therapy; Melanoma, Cutaneous Malignant; Metastasis; Middle Aged; Neoplasm Staging; Nursing; Odds Ratio; Out-of-pocket expenses; Patient Preference; Patients; Payments; People and Places; Physicians; Physicians - psychology; Preferences; Psoriasis; Quality of life; Risk assessment; Rosacea; Skin cancer; Skin diseases; Skin Neoplasms - economics; Skin Neoplasms - pathology; Skin Neoplasms - psychology; Skin Neoplasms - therapy; Social science research; Social Sciences; Studies; Surveys and Questionnaires; Tumors; Vitiligo; Willingness to pay
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0197780

Malignant melanoma is potentially life-threatening but in most cases curable if detected early. Willingness to pay (WTP) is a preference-based construct that reflects burden of disease by assessment of the monetary value for a hypothetical cure from disease. Since WTP (directly as total amount of money) has not been assessed so far in patients with low risk melanoma, it was interesting to gain insights in this patient population and then, in a second step, compare it directly with the WTP of their treating dermato-oncologists. WTP was assessed in 125 patients with low-risk melanoma and additionally in 105 treating physicians, asking for the one-time and continuous payments they would be willing to make for a sustainable cure, both as absolute sums and as percentages of monthly income. The median WTP based on one-time payment was €10,000 for patients and €100,000 for physicians; relative numbers were 100% versus 300% of monthly income. For continuous monthly payments, WTP was €500 for patients and €1000 for physicians, relative numbers 25% and 50% of income, respectively. Even after controlling for income differences, there was a significantly higher WTP in physicians for all four questions. Compared to patients with chronic skin diseases such as vitiligo, rosacea, atopic eczema and psoriasis, patients with low-risk melanoma showed a significantly higher WTP. Our data suggest that there is a relevant burden of disease even in patients with low-risk tumors. Higher WTP of physicians underlines the prevalence of differences in disease perception.