title: Patients' willingness to contribute to cost of novel implants in total joint arthroplasty.
abstract: As health care organizations adapt to more accountable financial models, it is increasingly important to assess how patients value new technologies, and their willingness to contribute to their cost. A questionnaire described features of a 'standard' implant including its longevity and risk of complications. We asked if participants would be willing to contribute to the cost of 3 novel implants with differing longevity and risk of complications. Our cohort included 195 patients, 45% were willing to add a co-pay to increase the longevity. Willingness to pay decreased to 26% with increased risk of complications, and 29% were willing to pay for a decreased risk of complications. Patients with higher education level, private insurance and males were more willing to contribute for a novel prosthesis. This study demonstrated that 26%-45% of patients are willing to share costs of a novel prosthesis. Willingness to pay was associated with the proposed implant benefits and with patient characteristics.
authors.affiliation: Department of Orthopaedic Surgery, University of California Irvine Medical Center, Orange, California.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
authors.affiliation: Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Stephanie P
authors.initials: SP
authors.lastname: Chen
authors.affiliation: Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Yan
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Donnell-Fink
authors.affiliation: Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Elena
authors.initials: E
authors.lastname: Losina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000191:economics*; D017047:Cost Sharing / Q000191:economics*; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D006801:Humans; D007595:Joint Prosthesis / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics; D011474:Prosthesis Design; D011795:Surveys and Questionnaires
keywords: co-pay; cost sharing; novel implants; total joint arthroplasty; willingness to pay