title: Quantifying the utility of taking pills for cardiovascular prevention.
abstract: BACKGROUND
  The decrease in utility attributed to taking pills for cardiovascular prevention can have major effects on the cost-effectiveness of interventions but has not been well studied. We sought to measure the utility of daily pill-taking for cardiovascular prevention.
  
  
  RESULTS
  We conducted a cross-sectional Internet-based survey of 1000 US residents aged ≥30 in March 2014. We calculated utility values, using time trade-off as our primary method and standard gamble and willingness-to-pay techniques as secondary analyses. Mean age of respondents was 50 years. Most were female (59%) and white (63%); 28% had less than a college degree; and 79% took ≥1 pills daily. Mean utility using the time trade-off method was 0.990 (95% confidence interval, 0.988-0.992), including ≈70% not willing to trade any amount of time to avoid taking a preventive pill daily. Using the standard gamble method, mean utility was 0.991 (0.989-0.993), with 62% not willing to risk any chance of death. Respondents were willing to pay an average of $1445 to avoid taking a pill daily, which translated to a mean utility of 0.994 (0.940-0.997), including 41% unwilling to pay any amount. Time trade-off-based utility varied by age (decreasing utility as age increased), sex, race, numeracy, difficulty with obtaining pills, and number of pills taken per day but did not vary by education level, literacy, or income.
  
  
  CONCLUSIONS
  Mean utility for taking a pill daily for cardiovascular prevention is ≈0.990 to 0.994.
authors: From the Department of Medicine, Division of General Internal Medicine, University of California San Francisco (R.H.); Health Care and Prevention MD-MPH Program (A.J.V., S.L.S.) and Gillings School of Global Public Health (A.J.V., S.L.S.), University of North Carolina at Chapel Hill School of Medicine; and Department of Family Medicine (A.J.V.) and Department of Medicine, Division of General Internal Medicine and Clinical Epidemiology (S.L.S., M.P.P.), University of North Carolina at Chapel Hill. rphutchins84@gmail.com.
authors: Robert
authors: R
authors: Hutchins
authors: From the Department of Medicine, Division of General Internal Medicine, University of California San Francisco (R.H.); Health Care and Prevention MD-MPH Program (A.J.V., S.L.S.) and Gillings School of Global Public Health (A.J.V., S.L.S.), University of North Carolina at Chapel Hill School of Medicine; and Department of Family Medicine (A.J.V.) and Department of Medicine, Division of General Internal Medicine and Clinical Epidemiology (S.L.S., M.P.P.), University of North Carolina at Chapel Hill.
authors: Anthony J
authors: AJ
authors: Viera
authors: From the Department of Medicine, Division of General Internal Medicine, University of California San Francisco (R.H.); Health Care and Prevention MD-MPH Program (A.J.V., S.L.S.) and Gillings School of Global Public Health (A.J.V., S.L.S.), University of North Carolina at Chapel Hill School of Medicine; and Department of Family Medicine (A.J.V.) and Department of Medicine, Division of General Internal Medicine and Clinical Epidemiology (S.L.S., M.P.P.), University of North Carolina at Chapel Hill.
authors: Stacey L
authors: SL
authors: Sheridan
authors: From the Department of Medicine, Division of General Internal Medicine, University of California San Francisco (R.H.); Health Care and Prevention MD-MPH Program (A.J.V., S.L.S.) and Gillings School of Global Public Health (A.J.V., S.L.S.), University of North Carolina at Chapel Hill School of Medicine; and Department of Family Medicine (A.J.V.) and Department of Medicine, Division of General Internal Medicine and Clinical Epidemiology (S.L.S., M.P.P.), University of North Carolina at Chapel Hill.
authors: Michael P
authors: MP
authors: Pignone
mesh_terms: D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D005715:Gambling; D019538:Health Care Surveys; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019338:Polypharmacy; D011314:Preventive Health Services / Q000191:economics; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D002317:Cardiovascular Agents
keywords: cost-utility analysis; prevention and control