title: Study of Patients' Willingness to Pay for a Cure of Chronic Obstructive Pulmonary Disease in Taiwan.
abstract: OBJECTIVE
  Chronic Obstructive Pulmonary Disease (COPD) is one of the fastest growing causes of death worldwide. However, few studies, if any, have been conducted that have investigated patient profiles in Asia. This paper analyzes patient willingness to pay (WTP) as a function of patient disease severity, health-related quality of life (HRQL), and smoking behavior in Taiwan.
  
  
  METHODS
  A cross-sectional survey was conducted using in-person interviews with COPD patients. A hypothetical scenario was designed and presented to ascertain each subject's willingness to pay (WTP) for a cure for COPD.
  
  
  METHODS
  A survey of subjects with COPD was performed in Taiwan. The contingent valuation method (CVM) was employed to measure patient financial burden, which was analyzed along with covariates that included various types of health-related quality of life (HRQL), severity level, and demographic background. Multivariate regression and simulation methods were employed for analysis.
  
  
  RESULTS
  A total of 142 subjects were interviewed, with an average annual WTP of approximately $1422 USD (or 42,662.37 NTD, New Taiwan Dollars). The annual WTP for patients 55 years of age or younger, $5709.06, was the highest and equivalent to approximately one-third of Taiwan average annual personal income or quadruple the spending amount of the Taiwan National Bureau of Health Insurance (NBHI) for each COPD patient. Current cigarette smokers were willing to pay a substantially higher amount than former smokers and nonsmokers, which reflects a psychological desire for redemption in COPD patients.
  
  
  CONCLUSIONS
  The results of this study provide directions for the relevant authorities regarding the alleviation of suffering as a result of COPD. Appropriate health promotion measures, such as measures to reduce tobacco usage, early diagnosis, and active treatment, may be necessary to contain the escalating costs related to COPD and to prevent this epidemic from worsening.
authors.affiliation: Hualien Buddhist Tzu-Chi General Hospital, Hualien City 970, Taiwan. yitingchen@tzuchi.com.tw.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Business Administration, National Taiwan Normal University, Taipei City 106, Taiwan. yyingnsysu@gmail.com.
authors.forename: Yung-Hsiang
authors.initials: YH
authors.lastname: Ying
authors.affiliation: Department of Healthcare Information and Management, Ming Chuan University; Taipei City 111, Taiwan. kychang@mail.mcu.edu.tw.
authors.forename: Koyin
authors.initials: K
authors.lastname: Chang
authors.affiliation: Department of Healthcare Information and Management, Ming Chuan University; Taipei City 111, Taiwan. hsieh_yahui@hotmail.com.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D011788:Quality of Life; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D013624:Taiwan / Q000453:epidemiology
keywords: chronic obstructive pulmonary disease (COPD); comorbidities; disease severity; health-related quality of life (HRQL); willingness to pay (WTP)