title: Patients' willingness-to-pay for an Alzheimer's disease medication in Canada.
abstract: BACKGROUND
  Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognition and function.
  
  
  OBJECTIVE
  The aim of this article is to assess whether persons with AD would support out-of-pocket payment for an AD medication; to elicit the monthly dollar amounts they would pay.
  
  
  METHODS
  We recruited persons with mild or moderate AD (n = 216) from nine clinics across Canada. During one-on-one interviews, we presented our sample with four scenarios describing a medication that either treated disease symptoms or modified the course of AD; each version of the medication was alternatively presented as having a 0 % or 30 % chance of adverse effects. For each scenario, participants indicated whether they would support paying out-of-pocket for the medication (yes/no). Affirmative responses were followed with questions asking participants whether they would pay $75, $150, or $225 (Canadian dollars) per month.
  
  
  RESULTS
  Levels of support ('yes' responses) ranged from 57 % to 83 % and mean willingness-to-pay ranged from $98 to $137, depending on scenario. Participants were more likely to provide affirmative responses and higher willingness-to-pay amounts when the medication modified disease or had a 0 % chance of adverse effects. Age was inversely associated with support in three scenarios and willingness-to-pay amounts in all four scenarios. Positive associations between post-secondary education and willingness-to-pay amounts were found in three scenarios.
  
  
  CONCLUSIONS
  Persons with mild or moderate AD were often willing to pay out-of-pocket for AD medications. However, the mean maximum willingness-to-pay ($137) for the optimal medication scenario was lower than the average monthly cost of existing AD medications.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University DTC, 50 Main Street East, 3rd Floor, Hamilton, ON, L8N 1E9, 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: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.forename: Natasha
authors.initials: N
authors.lastname: Clayton
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics*; D002170:Canada; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005382:Financing, Personal; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index