title: Women's willingness to pay out-of-pocket for drug treatment for osteoporosis before and after the enactment of regulations providing public funding: evidence from a natural experiment in Israel.
abstract: This study examines women's willingness to pay (WTP) for drug treatment for osteoporosis before and after the enactment of regulations approving public funding for the drugs and for a hypothetical more effective but not funded drug. One hundred and nine postmenopausal women recruited sequentially from a large bone metabolism outpatient clinic in central Israel were asked by telephone interview to report their maximum WTP out-of-pocket for a drug that would reduce the risk of hip fracture by 50% in four hypothetical cases varying by the level of risk described. Additionally, after the regulations, responses were elicited also for a hypothetical more effective drug. Information regarding participants' sociodemographic and health characteristics, as well as their knowledge of osteoporosis, was also collected. Women would pay considerable sums of money (between 85% to 124% of the price of the drugs) for osteoporosis treatment and these sums increase significantly as the risk of suffering a hip fracture increases. After the enactment of the regulations, women were still willing to pay 54% to 100% of the price of the drugs out-of-pocket. Increased WTP after the regulations was associated with increased ability to pay and to lower levels of knowledge of the disease. After the enactment, participants' WTP for a more effective drug was no different from their WTP for a less effective drug. WTP measures show relative stability over time. The dissemination of information regarding policy or regulatory changes should be encouraged in order to ensure rational decision-making processes.
authors: Department of Gerontology, University of Haifa, Mount Carmel, Israel.
authors: P
authors: P
authors: Werner
authors: I
authors: I
authors: Vered
mesh_terms: D000368:Aged; D016527:Drug Costs / Q000331:legislation & jurisprudence*; D005252:Fees, Pharmaceutical; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D012307:Risk Factors; D012923:Social Class