title: Effect of postoperative experiences on willingness to pay to avoid postoperative pain, nausea, and vomiting.
abstract: BACKGROUND
  The authors assessed the willingness to pay (WTP) for "perfect" prophylactic antiemetics and analgesics in patients who were scheduled to undergo surgery during general anesthesia. Furthermore, they determined whether postoperative experiences of pain and nausea and vomiting (PONV) changed patients' WTP.
  
  
  METHODS
  Data were collected alongside a randomized clinical trial that investigated the incidence of PONV in patients anesthetized with either inhalation anesthesia or total intravenous anesthesia. A subset of 808 consecutive patients participating in the trial completed WTP questionnaires 1 day before and 2 weeks after surgery. The outcome measure was the maximum amount of money that patients were willing to pay for "perfect" antiemetics and analgesics. Preoperative WTP and individual WTP changes after surgery were analyzed in relation to baseline characteristics and postoperative pain and PONV experiences.
  
  
  RESULTS
  Prevention of postoperative pain was valued higher than prevention of PONV. The median preoperative WTP for analgesics was US dollar 35 (interquartile range, dolalr 7-69) vs. US dollar 17 (interquartile range, dollar 7-69) for antiemetics. Individual WTP changes for antiemetics were not related to PONV experience, whereas severe postoperative pain (numerical rating score > or = 8) was associated with an increase in the WTP for analgesics.
  
  
  CONCLUSIONS
  Severe postoperative pain experiences increased patients' WTP for analgesics, but PONV did not increase WTP for antiemetics. The elicited WTP values were lower than those reported in previous studies, which is possibly related to differences in market culture or patients' attitudes toward postoperative pain, nausea, and vomiting.
authors.affiliation: Division of Perioperative Care and Emergency Medicine and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Jolanda E
authors.initials: JE
authors.lastname: van den Bosch
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: Karel G
authors.initials: KG
authors.lastname: Moons
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
mesh_terms: D000328:Adult; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use; D000932:Antiemetics / Q000191:economics / Q000627:therapeutic use; D001290:Attitude; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000191:economics* / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000191:economics* / Q000517:prevention & control*; D011184:Postoperative Period; D011997:Recovery Room; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D000932:Antiemetics