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The General Public’s Willingness to Pay for Tax Increases to Support Unrestricted Access to an Alzheimer’s Disease Medication

Abstract

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.

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Acknowledgements

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.

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Correspondence to Dr Mark Oremus PhD.

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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

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Keywords

  • Memantine
  • Unrestricted Access
  • Study Design Variable
  • Polling Firm
  • Public Drug Plan