title: Patient preferences and willingness to pay for innovations in intermittent self-catheters.
abstract: BACKGROUND
  Intermittent catheterization is the gold standard for bladder management in Europe in people with spinal cord injuries. The aim of the present study was to identify and investigate individuals' preferences regarding intermittent self-catheterization (ISC) devices and furthermore investigate the willingness to pay for attributes in ISC devices in the UK, France, and the Netherlands.
  
  
  METHODS
  A discrete choice experiment survey was conducted to evaluate the patients' perceived value of catheter features. Attributes were selected based upon a literature review of the most important characteristics of catheters and the survey was developed and validated with input from patients and medical experts. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log) odds ratios of preference for attributes. Willingness to pay was estimated for all levels of the attributes.
  
  
  RESULTS
  Two-hundred and eighty-three participants completed the questionnaire and were included in data analysis. Risk of infection had the highest odds ratios as preferred important attribute for all three countries followed by ease of insertion. "Pre-coated catheters" was found to be valued as the most preferred coating technology across all countries. Out of pocket cost was a significant influence on patients' choice.
  
  
  CONCLUSIONS
  Users of ISC perceive the value of convenience (size of catheter), ease of insertion, and reduced risk of infection as the most important features attached to an intermittent catheter. These results are applicable both for the "classic" ISC user as well as for another broad group of catheter dependent individuals.
authors.affiliation: ICON plc, Oxford, UK.
authors.forename: Binny
authors.initials: B
authors.lastname: Pinder
authors.affiliation: ICON plc, Oxford, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lloyd
authors.affiliation: ICON plc, Oxford, UK.
authors.forename: Beenish
authors.initials: B
authors.lastname: Nafees
authors.affiliation: ICON plc, San Francisco, CA, USA.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Elkin
authors.affiliation: School of Nursing, University of Ulster, Newtownabbey, UK.
authors.forename: Jerome
authors.initials: J
authors.lastname: Marley
keywords: discrete choice experiment; perceived value; self-intermittent catheterization; utility
references.citation: J Adv Nurs. 2008 Apr;62(1):32-40
references.pmid: 18352962
references.citation: J Urol. 2013 Sep;190(3):942-7
references.pmid: 23587630
references.citation: J Adv Nurs. 2008 Mar;61(6):641-50
references.pmid: 18302605
references.citation: Clin Ther. 2012 Dec;34(12 ):2302-13
references.pmid: 23178033
references.citation: Eur Urol. 2009 Jul;56(1):81-8
references.pmid: 19403235
references.citation: J Spinal Cord Med. 2006;29(5):527-73
references.pmid: 17274492
references.citation: J Health Econ. 2006 May;25(3):520-37
references.pmid: 16243406
references.citation: Appl Health Econ Health Policy. 2003;2(1):55-64
references.pmid: 14619274
references.citation: Med Care. 1997 Nov;35(11):1095-108
references.pmid: 9366889
references.citation: J Hosp Infect. 2012 Dec;82(4):274-6
references.pmid: 23103248
references.citation: J Urol. 2004 Dec;172(6 Pt 1):2321-5
references.pmid: 15538258
references.citation: J Pak Med Assoc. 2006 Sep;56(9):401-4
references.pmid: 17091752
references.citation: Soc Sci Med. 2003 Feb;56(4):803-14
references.pmid: 12560013
references.citation: J Urol. 2001 Jul;166(1):130-3
references.pmid: 11435839
references.citation: Scand J Urol Nephrol. 2007;41(4):341-5
references.pmid: 17763228
references.citation: Cochrane Database Syst Rev. 2005 Jul 20;(3):CD004203
references.pmid: 16034924
references.citation: Spinal Cord. 2011 Jul;49(7):817-21
references.pmid: 21358718
references.citation: J Am Geriatr Soc. 1994 Dec;42(12):1286-90
references.pmid: 7983294