Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T02:57:28.376Z Has data issue: false hasContentIssue false
  • English
  • Français

Willingness to pay for allergy-vaccination among Danish patients with respiratory allergy

Published online by Cambridge University Press:  08 January 2010

Karin Dam Petersen ,
Dorte Gyrd-Hansen ,
Allan Linneberg ,
Ronald Dahl ,
Jørgen Nedergaard Larsen ,
Henning Løwenstein  and
Christian Kronborg
Karin Dam Petersen
Affiliation:
University of Southern Denmark
Dorte Gyrd-Hansen
Affiliation:
University of Southern Denmark
Allan Linneberg
Affiliation:
Glostrup University Hospital
Ronald Dahl
Affiliation:
Aarhus University Hospital
Jørgen Nedergaard Larsen
Affiliation:
ALK-Abelló
Henning Løwenstein
Affiliation:
ALK-Abelló
Christian Kronborg
Affiliation:
University of Southern Denmark
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The aim of this study was to elicit willingness to pay (WTP) for allergen-specific subcutaneous injection immunotherapy (SCIT) in a cohort of respondents suffering from allergic-rhinoconjunctivitis (a-RC)/asthma, and to investigate how patients self-select to SCIT according to need.

Methods: A random sample of the general population was screened for a-RC/asthma and asked if they were willing to consider SCIT. They were asked to state their WTP for SCIT by way of a discrete choice question (DC-q), an open-ended WTP question (o-WTP-q), and questions relating to their sociodemographic background and the severity of their a-RC/asthma. The characteristics of respondents demanding SCIT were compared with the characteristics of respondents who have actually received SCIT to establish possible barriers to demand.

Results: Our results suggest that respondents do well in self-selecting themselves to SCIT on the basis of need according to disease burden measured in terms of a-RC classification, number of contacts with a general practitioner, number of sick days, and potential quality-adjusted life-year loss. Mean WTP for SCIT was estimated at €655 (median, €267) (o-WTP-q) and €903 (95 percent confidence limit, 348–1,459) (DC-q).

Conclusion: Characteristics of respondents, who consider SCIT and are willing to pay for SCIT, suggest that allergy sufferers select themselves appropriately according to need and not according to other characteristics, such as income or education. There is a significant discrepancy between those who hypothetically consider SCIT and those demanding SCIT in real life. This study suggests that there are barriers to entry related to age and education, but not to income.

Keywords

Willingness to pay (WTP)Allergy-specific subcutaneous injection immunotherapy (SCIT)Quality-adjusted life-years (QALY)EQ-5DAllergic-rhinoconjunctivitis
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 1 , January 2010 , pp. 20 - 29
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Ajzen, I, Brown, TC, Carvajal, F. Explaining the discrepancy between intentions and actions: The case of hypothetical bias in contingent valuation. Pers Soc Psychol Bull. 2004;30:1108–1121.CrossRefGoogle ScholarPubMed
2. Bousquet, J, Khaltaev, N, Cruz, AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update [in collaboration with the World Health Organization, GA(2) LEN and AllerGen]. Allergy. 2008;63 (Suppl 86):8–160.CrossRefGoogle Scholar
3. Bala, MV, Wood, LL, Zarkin, GA, et al. Valuing outcomes in health care: A comparison of willingness to pay and quality-adjusted life-years. J Clin Epidemiol. 1998;51:667–676.CrossRefGoogle Scholar
4. Bateman, IJ, Carson, RT, Day, Brett et al. , Economic valuation with stated preference techniques. A manual. Published for the Department of Transport under license from the Controller of her Majesty's Stationery Office by Edward Elgar Publishing Limited Glensanda House, Montpellier Parade, Cheltenham, Glos GL50 1UA, UK; 2002.Google Scholar
5. Bodtger, U, Linneberg, A. Remission of allergic rhinitis: An 8-year observational study. J Allergy Clin Immunol. 2004;114:1384–1388.CrossRefGoogle ScholarPubMed
6. Bousquet, J, Clark, TJ, Hurd, S, et al. GINA guidelines on asthma and beyond. Allergy. 2007;62:102–112.CrossRefGoogle ScholarPubMed
7. Calderon, MA, Alves, B, Jacobson, M, et al. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev. 2007;1:CD001936.Google Scholar
8. Des Roches, A, Paradis, L, Menardo, JL, et al. Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. VI. Specific immunotherapy prevents the onset of new sensitizations in children. J Allergy Clin Immunol. 1997;99:450–453.CrossRefGoogle ScholarPubMed
9. Durham, SR, Walker, SM, Varga, EM, et al. Long-term clinical efficacy of grass-pollen immunotherapy. N Engl J Med. 1999;341:468–475.CrossRefGoogle ScholarPubMed
10. Folland, S, Goodman, AC, Stano, M. The economics of health and health care. Oakland: Prentice Hall; 2007.Google Scholar
11. Green, WH. Econometric analysis. Englewood Cliffs: Prentice Hall; 1993.Google Scholar
12. Jacobsen, L, Niggemann, B, Dreborg, S, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007;62:943–948.CrossRefGoogle ScholarPubMed
13. Jarvis, D, Luczynska, C, Chinn, S, et al. Change in prevalence of IgE sensitization and mean total IgE with age and cohort. J Allergy Clin Immunol. 2005;116:675–682.CrossRefGoogle ScholarPubMed
14. Juniper, EF, Thompson, AK, Ferrie, PJ, et al. Validation of the standardized version of the Rhinoconjunctivitis Quality of Life Questionnaire. J Allergy Clin Immunol. 1999;104 (pt 1):364–369.CrossRefGoogle ScholarPubMed
15. Kind, P, Dolan, P, Gudex, C, et al. Variations in population health status: Results from a United Kingdom national questionnaire survey. BMJ. 1998;316:736–741.CrossRefGoogle ScholarPubMed
16. Koopmanschap, MA, Rutten, FF, van Ineveld, BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ. 1995;14:171–189.CrossRefGoogle ScholarPubMed
17. Linneberg, A, Gislum, M, Johansen, N, et al. Temporal trends of aeroallergen sensitization over twenty-five years. Clin Exp Allergy. 2007;37:1137–1142.CrossRefGoogle ScholarPubMed
18. Linneberg, A, Nielsen, NH, Madsen, F, et al. Increasing prevalence of specific IgE to aeroallergens in an adult population: Two cross-sectional surveys 8 years apart: The Copenhagen Allergy Study. J Allergy Clin Immunol. 2000;106:247–252.CrossRefGoogle Scholar
19. Pajno, GB, Barberio, G, De Luca, F, Morabito, L, Parmiani, S. Prevention of new sensitizations in asthmatic children monosensitized to house dust mite by specific immunotherapy. A six-year follow-up study. Clin Exp Allergy. 2001;31:1392–1397.CrossRefGoogle ScholarPubMed
20. Pedersen, KM, Wittrup-Jensen, K, Brooks, R, et al. Værdisætning af sundhed. Teorien om kvalitetsjusterede leveår og en dansk anvendelse (In Danish: Valuation of health. Theory of quality adjusted life years). Odense: University of Southern Denmark; 2003.Google Scholar
21. Petersen, KD, Gyrd-Hansen, D, Dahl, R. Health-economic analyses of subcutaneous specific immunotherapy for grass pollen and mite allergy. Allergol Immunopathol (Madr). 2005;33:296–302.CrossRefGoogle ScholarPubMed
22. Petersen, KD, Kronborg, C, Gyrd-Hansen, D, et al. Quality of life in rhinoconjunctivitis assessed with generic and disease-specific questionnaires. Allergy. 2008;63:284–291.CrossRefGoogle ScholarPubMed
23. Smith, RD. The relative sensitivity of willingness-to-pay and time-trade-off to changes in health status: An empirical investigation. Health Econ. 2001;10:487–497.CrossRefGoogle ScholarPubMed
24. Ubel, PA, Loewenstein, G, Jepson, C. Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Qual Life Res. 2003;12:599–607.CrossRefGoogle ScholarPubMed
25. Walker, SM, Pajno, GB, Lima, MT, et al. Grass pollen immunotherapy for seasonal rhinitis and asthma: A randomized, controlled trial. J Allergy Clin Immunol. 2001;107:87–93.CrossRefGoogle ScholarPubMed