Background: Alzheimer’s disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognitive and functional abilities.
Objective: Our objective was to assess the general public’s maximum willingness to pay MWTP for an increase in annual personal income taxes to fund unrestricted access to AD medications.
Methods: We randomly recruited 500 Canadians nationally and used computer-assisted telephone interviewing to administer a questionnaire. The questionnaire contained four ‘efficacy’ scenarios describing an AD medication as capable of symptomatically treating cognitive decline or modifying disease progression. The scenarios also described the medication as having no adverse effects or a 30% chance of adverse effects. We randomized participants to order of scenarios and willingness-to-pay bid values; MWTP for each scenario was the highest accepted bid for that scenario. We conducted linear regression and bootstrap sensitivity analyses to investigate potential determinants of MWTP.
Results: Mean MWTP was highest for the ‘disease modification/no adverse effects’ scenario ($Can130.26) and lowest for the ‘symptomatic treatment/30% chance of adverse effects’ scenario ($Can99.16). Bootstrap analyses indicated none of our potential determinants (e.g. age, sex) were associated with participants’ MWTP.
Conclusions: The general public is willing to pay higher income taxes to fund unrestricted access to AD (especially disease-modifying) medications. Consequently, the public should favour placing new AD medications on public drug plans. As far as we are aware, no other study has elicited the general public’s willingness to pay for AD medications.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Burns A, Iliffe S. Alzheimer’s disease. BMJ 2009; 338: 467–71.
Querfurth HW, LaFerla FM. Alzheimer’s disease. N Engl J Med 2010; 362: 329–44.
Wolfson C, Wolfson DB, Asgharian M, et al. A reevaluation of the duration of survival after the onset of dementia. N Engl J Med 2001; 344: 1111–6.
Alzheimer’s Association. 2009 Alzheimer’s disease facts and figures. Alzheimers Dement 2009; 5: 234–70.
Hebert LE, Scherr PA, Bienias JL, et al. Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol 2003; 60: 1119–22.
Canadian Study of Health and Aging. Canadian Study of Health and Aging: study methods and prevalence of dementia. CMAJ 1994; 150: 899–913.
Ostbye T, Crosse E. Net economic costs of dementia in Canada. CMAJ 1994; 151: 1457–64.
Raina P, Santaguida P, Ismaila A, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med 2008; 148: 379–97.
Zarit S, Orr N, Zarit J. The hidden victims of Alzheimer’s disease: families under stress. New York: New York University Press, 1985.
Oremus M, Tarride JE, Clayton N, et al. Support for a tax increase to provide unrestricted access to an Alzheimer’s disease medication: a survey of the general public in Canada. BMC Health Serv Res 2009; 9: 246.
Dieckmann L, Zarit SH, Zarit JM, et al. The Alzheimer’s Disease Knowledge Test. Gerontologist 1988; 28: 402–7.
EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Pol 1990; 16: 199–208.
Massoud F, Léger GC. Pharmacological treatment of Alzheimer disease. Can J Psychiatry 2011 Oct; 56 (10): 579–88.
Bank of Canada. Monthly average exchange rates: 10-year lookup [online]. Available from URL: http://www.bankofcanada.ca/en/rates/exchange-avg.html [Accessed 2011 Jan 3].
Efron B, Tibshirani RJ. An introduction to the bootstrap. New York: Chapman and Hall, 1993.
Oremus M, Tarride JE. A systematic review of the use of contingent valuation in Alzheimer’s disease research. Dement Int J Soc Res Pract 2008; 7: 461–80.
Chiu L, Tang K-Y, Liu Y-H, et al. Willingness of families caring for victims of dementia to pay for nursing home care: results of a pilot study in Taiwan. J Manag Med 1998; 12: 349–60.
Konig M, Wettstein A. Caring for relatives with dementia: willingness-to-pay for a reduction in caregiver’s burden. Expert Rev Pharmacoecon Outcomes Res 2002; 2: 535–47.
Nocera S, Bonato D, Telser H. The contingency of contingent valuation: how much are people willing to pay against Alzheimer’s disease? Int J Health Care Finance Econ 2002; 2: 219–40.
Werner P, Schnaider-Beeri M, Aharon J, et al. Family caregivers’ willingness to pay for drugs indicated for the treatment of Alzheimer’s disease. Dementia 2002; 1: 59–74.
Wu G, Lanctot KL, Herrmann N, et al. The cost-benefit of cholinesterase inhibitors in mild to moderate dementia: a willingness-to-pay approach. CNS Drugs 2003; 17: 1045–57.
Negrin MA, Pinilla J, Leon CJ. Willingness to pay for alternative policies for patients with Alzheimer’s disease. Health Econ Policy Law 2008; 3: 257–75.
Bayoumi AM. The measurement of contingent valuation for health economics. Pharmacoeconomics 2004; 22: 691–700.
Gustavsson A, Jonsson L, McShane R, et al. Willingness-to-pay for reductions in care need: estimating the value of informal care in Alzheimer’s disease. Int J Geriatr Psychiatry 2010; 25: 622–32.
Konig M, Zweifel P. Willingness-to-pay against dementia: effects of altruism in between patients and their spouse caregivers [working paper no. 0410]. Zurich: Socio-economic Institute — University of Zurich, 2004.
Raina PS, Wolfson C, Kirkland SA, et al. The Canadian Longitudinal Study on Aging (CLSA). Can J Aging 2009; 28: 221–9.
Rafii MS. The pulse of drug development for Alzheimer’s disease. Rev Recent Clin Trials 2010; 5: 57–62.
Mark Oremus and Jean-Eric Tarride are funded by Career Scientist Awards from the Ontario Ministry of Health and Long-Term Care. Mark Oremus holds the McLaughlin Foundation Professorship in Population and Public Health.
Parminder Raina holds a Tier 1 Canada Research Chair in Geroscience and the Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging.
Charlie Goldsmith is currently employed by the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada and in the Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada. Dr Goldsmith is the Maureen and Milan Ilich/Merck Chair in Statistics for Arthritis and Musculoskeletal Diseases at the Arthritis Research Centre of Canada and Simon Fraser University.
The authors wish to thank Leger Marketing for conducting the general public survey.
The Canadian Institutes of Health Research funded this study (grant no. MOP 86487).
Mark Oremus was involved in the conceptualization and design of the study, and he wrote the draft manuscript. Jean-Eric Tarride contributed to the conceptualization and design of the study, and critically revised drafts of the manuscript. Parminder Raina critically reviewed the manuscript for important scientific content and contributed to the interpretation of the data. Lehana Thabane, Gary Foster and Charlie Goldsmith developed the analysis plan, conducted the analyses and critically revised drafts of the manuscript. Lehana Thabane also drafted portions of the Methods section in the manuscript. Natasha Clayton cleaned the data, assisted with analyses and critically revised drafts of the manuscript. All authors read and approved the final manuscript.
Mark Oremus acts as guarantor for the overall content of the article.
About this article
Cite this article
Oremus, M., Tarride, J., Raina, P. et al. The General Public’s Willingness to Pay for Tax Increases to Support Unrestricted Access to an Alzheimer’s Disease Medication. PharmacoEconomics 30, 1085–1095 (2012). https://doi.org/10.2165/11594180-000000000-00000
- Unrestricted Access
- Study Design Variable
- Polling Firm
- Public Drug Plan