title: Willingness to pay for drug rehabilitation: implications for cost recovery.
abstract: OBJECTIVE
  This study estimates the value that clients place on methadone maintenance and how this value varies with the effectiveness of treatment and availability of case management. We provide the first estimate of the price elasticity of the demand for drug treatment.
  
  
  METHODS
  We interviewed 241 heroin users who had been referred to, but had not yet entered, methadone maintenance treatment in Baltimore, Maryland. We asked each subject to state a preference among three hypothetical treatment programs that varied across three domains: weekly fee paid by the client out-of-pocket ($5-$100), presence/absence of case management, and time spent heroin-free (3-24 months). Each subject was asked to complete 18 orthogonal comparisons. Subsequently each subject was asked if they likely would enroll in their preferred choice among the set of three. We computed the expected willingness to pay (WTP) as the probability of enrollment times the fee considered in each choice considered from a multivariate logistic model that controlled for product attributes. We also estimated the price elasticity of demand.
  
  
  RESULTS
  The median expected fee subjects were willing to pay for a program that offered 3 months of heroin-free time was $7.30 per week, rising to $17.11 per week for programs that offered 24 months of heroin-free time. The availability of case management increased median WTP by $5.64 per week. The price elasticity was -0.39 (S.E. 0.042).
  
  
  CONCLUSIONS
  Clients will pay more for higher rates of treatment success and for the presence of case management. Clients are willing to pay for drug treatment but the median willingness to pay falls short of the estimated program costs of $82 per week. Thus a combined approach of user fees and subsidization may be the optimal financing strategy for the drug treatment system.
authors.affiliation: Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, United States.
authors.forename: D
authors.initials: D
authors.lastname: Bishai
authors.affiliation: Yale University, New Haven, CT, United States.
authors.forename: J
authors.initials: J
authors.lastname: Sindelar
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: E P
authors.initials: EP
authors.lastname: Ricketts
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: S
authors.initials: S
authors.lastname: Huettner
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: L
authors.initials: L
authors.lastname: Cornelius
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: J J
authors.initials: JJ
authors.lastname: Lloyd
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: J R
authors.initials: JR
authors.lastname: Havens
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: C A
authors.initials: CA
authors.lastname: Latkin
authors.affiliation: National Bureau of Economic Research, United States.
authors.forename: S A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000328:Adult; D005260:Female; D005382:Financing, Personal; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012046:Rehabilitation / Q000191:economics*; D019966:Substance-Related Disorders / Q000534:rehabilitation*