title: The general public's willingness to pay for tax increases to support unrestricted access to an Alzheimer's disease medication.
abstract: BACKGROUND
  Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognitive and functional abilities.
  
  
  OBJECTIVE
  Our objective was to assess the general public's maximum willingness to pay ((M)WTP) for an increase in annual personal income taxes to fund unrestricted access to AD medications.
  
  
  METHODS
  We randomly recruited 500 Canadians nationally and used computer-assisted telephone interviewing to administer a questionnaire. The questionnaire contained four 'efficacy' scenarios describing an AD medication as capable of symptomatically treating cognitive decline or modifying disease progression. The scenarios also described the medication as having no adverse effects or a 30% chance of adverse effects. We randomized participants to order of scenarios and willingness-to-pay bid values; (M)WTP for each scenario was the highest accepted bid for that scenario. We conducted linear regression and bootstrap sensitivity analyses to investigate potential determinants of (M)WTP.
  
  
  RESULTS
  Mean (M)WTP was highest for the 'disease modification/no adverse effects' scenario ($Can130.26) and lowest for the 'symptomatic treatment/30% chance of adverse effects' scenario ($Can99.16). Bootstrap analyses indicated none of our potential determinants (e.g. age, sex) were associated with participants' (M)WTP.
  
  
  CONCLUSIONS
  The general public is willing to pay higher income taxes to fund unrestricted access to AD (especially disease-modifying) medications. Consequently, the public should favour placing new AD medications on public drug plans. As far as we are aware, no other study has elicited the general public's willingness to pay for AD medications.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. oremusm@mcmaster.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Oremus
authors.forename: Jean-Eric
authors.initials: JE
authors.lastname: Tarride
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.forename: Gary
authors.initials: G
authors.lastname: Foster
authors.forename: Charlie H
authors.initials: CH
authors.lastname: Goldsmith
authors.forename: Natasha
authors.initials: N
authors.lastname: Clayton
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D002170:Canada; D003072:Cognition Disorders / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D018450:Disease Progression; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000191:economics / Q000600:supply & distribution*; D011795:Surveys and Questionnaires; D013660:Taxes / Q000191:economics
chemical_list: D004364:Pharmaceutical Preparations