EVALUATION OF PATIENT PREFERENCE AND WILLINGNESS TO PAY FOR ATTRIBUTES OF MAINTENANCE MEDICATION FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Chronic obstructive pulmonary disease (COPD) is a general disease, and the cause of a significant healthcare concern1. Deaths from COPD is now fourth-ranked in the world and is forecast to become the third leading cause of death by the year 20202. The chronic inflammation of the low-grade airways is founded in COPD3, and there are multiple inflammatory biomarkers have been reported to be involved in the increasing risk of death in COPD patients4, for example, C-reactive protein (CRP)5,6, surfactant protein D (SPD)7 and interleukin 6 (IL-6)8. The clinical characteristics of COPD patients are featured by three main symptoms: progressive dyspnea, cough, and chronic sputum production. COPD management goals concentrate on symptom alleviation, ameliorating health conditions, improving quality of life, and preventing and limiting the exacerbations' negative effect. COPD treatment is involved, including life-style changes with quit smoking is key, pharmacology, and non-pharmacology. In almost COPD patients, maintenance medications and quit-acting bronchodilators are indispensable9. In the maintenance management of COPD, medication adherence is very important. Patients with better adherence to drug therapy have been identified to have fewer hospitalization rates, lower money spending for Medicare, and better clinical outcomes10. There is a significant association between the rate of adherence to COPD medications with age, current smoking status, and a number of respiratory drugs11. Besides, patient beliefs, experiences, and behaviors also play an essential role in the adherence medications12. Although multiple factors influence the adherence to COPD patients' treatment, it is essential to understand their preference regarding their maintenance medications. Several attributes of patient’s perspectives are essential such as: efficacy, cost, ease of use, speed of onset, and side effect of medications13–16. Discrete choice experiment (DCE) is a helpful tool and is regularly implemented in health economics to explore patients' preferences for healthcare17,18. In DCEs, participants were required to complete a series of questions from hypothetical scenarios in which they must choose one most preference treatment. So their attitudes can be discovered in real-world decisions13,17. Maintenance medication adherence of COPD patients is a big challenge to the health care network in Viet Nam. However, the attribute preference of the patient to their medication is not yet adequately concerned. This study aims to assess and identify patients with COPD's maintenance medication preferences in this population, with DCE methodology. Research on this feature can help physicians have more evidence to make a choice before diverse clinical situations and improve patient outcomes. Thus, we decide to conduct the study “Evaluation of patient preference and willingness to pay for attributes of maintenance medication for chronic obstructive pulmonary disease” with 2 specific objectives: 1. To evaluate preference of chronic obstructive pulmonary disease patients for maintenance medications. 2. To describe the willingness to pay of chronic obstructive pulmonary disease patients for maintenance medications.