title: [Estimation on the intangible cost and influencing factors for patients with hepatitis B-related diseases].
abstract: OBJECTIVE
  To estimate the intangible cost and associated factors on patients with hepatitis B-related diseases, so as to explore the differences of the three elicitation techniques on the 'willingness to pay approach' (WTP).
  
  
  METHODS
  Face-to-Face interviews were conducted to collect health economics-related information by trained investigators, using a structured questionnaire. WTP was employed to estimate the intangible cost while an open-ended question format, together with iterative bidding game and payment card were respectively used to elicit WTP for the hypothetical cure of hepatitis B-related diseases. A Multiple linear stepwise regression model was determined to identify those factors potentially affecting the intangible cost.
  
  
  RESULTS
  A total of 564 subjects from 641 patients with hepatitis B-related diseases were identified for the inclusion of this study. The average annual intangible cost of patient with hepatitis B-related diseases was 54 320.4 Yuan (Ren Minbi). The intangible cost accounted for 53.0% of the total cost, which was much more than the proportions of the direct and indirect costs (38.5% and 8.5%, respectively). Among annual personal and the household income of the patient, proportions of intangible cost were 262.6% and 67.6% respectively, suggesting that the patients were under huge spiritual and psychological pressure. Response rate of the approach, combined open-ended questions with iterative bidding game, was the highest (76.6%) among the three elicitation formats. Considered the characteristics of data being gathered, the approach seemed to be more reasonable. Further studies were needed to examine the results yielded from other WTP elicitation formats. We also noticed that the progression of disease was associated with the increase of direct and indirect costs, but not with the intangible cost. Data from the multiple linear stepwise regression analysis indicated that the types of hospital and commercial medical insurance were significantly different in explaining the variation of the intangible cost.
  
  
  CONCLUSIONS
  Measures should be taken to reduce the intangible cost of hepatitis B-related diseases. The approach regarding the combination of open-ended questions with iterative bidding game should be recommended when carrying our further WTP studies of this kind.
authors.affiliation: College of Public Health, Guangdong Pharmaceutical University, Guangzhou 510305, China; Shenzhen Center for Disease Control and Prevention.
authors.forename: Qi-shan
authors.initials: QS
authors.lastname: Ma
authors.forename: Yu-hua
authors.initials: YH
authors.lastname: Zou
authors.forename: Shun-xiang
authors.initials: SX
authors.lastname: Zhang
authors.forename: Sen
authors.initials: S
authors.lastname: Liang
authors.forename: He-wei
authors.initials: HW
authors.lastname: Xiao
authors.forename: Xu
authors.initials: X
authors.lastname: Xie
authors.forename: Shu-jiang
authors.initials: SJ
authors.lastname: Mei
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Jia
authors.forename: Yu-feng
authors.initials: YF
authors.lastname: Zhang
authors.forename: Fu-qiang
authors.initials: FQ
authors.lastname: Cui
authors.forename: Fu-zhen
authors.initials: FZ
authors.lastname: Wang
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Liang
mesh_terms: D000328:Adult; D002681:China; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000191:economics* / Q000628:therapy; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult