title: Willingness to pay for a dengue vaccine and its associated determinants in Indonesia: A community-based, cross-sectional survey in Aceh.
abstract: Vaccination strategies are being considered as a part of dengue prevention programs in endemic countries. To accelerate the introduction of dengue vaccine into the public sector program and private markets, understanding the private economic benefits of a dengue vaccine is therefore essential. The aim of this study was to assess the willingness to pay (WTP) for a dengue vaccine among community members in Indonesia and its associated explanatory variables. A community-based, cross-sectional survey was conducted in nine regencies of Aceh province, Indonesia, from November 2014 to March 2015. A pre-tested validated questionnaire was used to facilitate the interviews. To assess the explanatory variables influencing participants' WTP for a dengue vaccine, a linear regression analysis was employed. We interviewed 677 healthy community members; 476 participants (87.5% of the total) were included in the final analysis. An average individual was willing to pay around US-$ 4 (mean: US-$ 4.04; median: US-$ 3.97) for a dengue vaccine. Our final multivariate model revealed that working as a civil servant, living in the city, and having good knowledge on dengue viruses, a good attitude towards dengue, and good preventive practice against dengue virus infection were associated with a higher WTP (P<0.05). Our model suggests that marketing efforts should be directed to community members who are working in the suburbs especially as farmers. In addition, the results of our study underscore the need for low-cost quality vaccines, public sector subsidies for vaccinations, and intensifying efforts to further educate and encourage households regarding other dengue preventive measures, using trusted individuals as facilitators.
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia; Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia. Electronic address: harapan@unsyiah.ac.id.
authors.forename: Harapan
authors.initials: H
authors.lastname: Harapan
authors.affiliation: Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Samsul
authors.initials: S
authors.lastname: Anwar
authors.affiliation: Department of Biology, Faculty of Teacher Training and Education, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Aslam
authors.initials: A
authors.lastname: Bustamam
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Arsil
authors.initials: A
authors.lastname: Radiansyah
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Pradiba
authors.initials: P
authors.lastname: Angraini
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Riny
authors.initials: R
authors.lastname: Fasli
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Salwiyadi
authors.initials: S
authors.lastname: Salwiyadi
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Reza Akbar
authors.initials: RA
authors.lastname: Bastian
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Ade
authors.initials: A
authors.lastname: Oktiviyari
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Imaduddin
authors.initials: I
authors.lastname: Akmal
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Iqbalamin
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Jamalul
authors.initials: J
authors.lastname: Adil
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Fenni
authors.initials: F
authors.lastname: Henrizal
authors.affiliation: Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Darmayanti
authors.initials: D
authors.lastname: Darmayanti
authors.affiliation: Department of Biology, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Mahmuda
authors.initials: M
authors.lastname: Mahmuda
authors.affiliation: Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.
authors.forename: Mudatsir
authors.initials: M
authors.lastname: Mudatsir
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Imrie
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: R Tedjo
authors.initials: RT
authors.lastname: Sasmono
authors.affiliation: Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kuch
authors.affiliation: Center for Statistics, Hasselt University, Diepenbeek, Belgium.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Shkedy
authors.affiliation: Institute of Statistics, Jakarta, Indonesia.
authors.forename: Setia
authors.initials: S
authors.lastname: Pramana
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003715:Dengue / Q000517:prevention & control / Q000523:psychology*; D053059:Dengue Vaccines / Q000191:economics*; D003716:Dengue Virus; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D064368:Healthy Volunteers; D006801:Humans; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D010358:Patient Participation / Q000191:economics / Q000523:psychology*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000191:economics / Q000523:psychology*
chemical_list: D053059:Dengue Vaccines
keywords: Dengue fever; Dengue vaccine; Indonesia; Vaccine demand; Vaccine introduction; Willingness to pay