title: Willingness-to-pay and quality of life in patients with vitiligo.
abstract: BACKGROUND
  Vitiligo is a chronic pigmentary disorder of the skin, affecting 1-2% of the general population. Although not life threatening, vitiligo may considerably influence patients' health-related quality of life (QoL) and psychological well-being. Willingness-to-pay (WTP) is a construct reflecting disease burden and QoL reduction which has not yet been used in vitiligo.
  
  
  OBJECTIVE
  To assess the WTP and the QoL of patients with vitiligo.
  
  
  METHODS
  Patients with vitiligo were included in a nationwide German postal survey. WTP was assessed by two standardized items, and QoL was evaluated using the Dermatology Life Quality Index (DLQI) and the EuroQol (EQ-5D) questionnaire. QoL data were compared with n = 1,511 patients from a national survey on psoriasis.
  
  
  RESULTS
  The questionnaire was completed by 1,023 patients (71.5% women, mean age 44.4 years, mean disease duration 20.3 years) with vitiligo. The mean DLQI was 7.0 (7.5 in women, 5.5 in men) compared with 8.6 in psoriasis. Of the patients with vitiligo, 24.6% had a DLQI > 10 which indicates severe QoL reductions, compared with 34.1% in patients with psoriasis. The highest mean DLQI value was observed in the patient group aged 20-29 years. EQ-5D mean score was 83.6 compared with 75.3 in psoriasis. Of the patients with vitiligo, 32.9% would pay more than 5,000 Euro in order to achieve complete disease remission. WTP was highest among middle-aged patients (30-60 years). There was a significant correlation between DLQI scores and WTP (chi(2) = 65.43, P < 0.001). Moreover, WTP significantly correlated with duration of disease, and with body surface area affected (P < 0.001).
  
  
  CONCLUSIONS
  Vitiligo causes substantial disease burden as reflected by QoL impairment and high WTP, especially in women. These results should draw the attention of physicians to this disease, as appropriate education and treatment are likely to improve the QoL of patients with vitiligo and may support patients' compliance and empowerment.
authors.affiliation: Department of Dermatology, CVderm - German Center for Health Services Research in Dermatology, University Clinics of Hamburg, Martinistrasse 52, Hamburg 20246, Germany. m.radtke@uke.uni-hamburg.de
authors.forename: M A
authors.initials: MA
authors.lastname: Radtke
authors.forename: I
authors.initials: I
authors.lastname: Schäfer
authors.forename: A
authors.initials: A
authors.lastname: Gajur
authors.forename: A
authors.initials: A
authors.lastname: Langenbruch
authors.forename: M
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005249:Fees and Charges; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000191:economics / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014820:Vitiligo / Q000191:economics / Q000523:psychology* / Q000628:therapy; D055815:Young Adult