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Leah Kleinman, DrPH; Emma McIntosh, MSc; Mandy Ryan, PhD; Jordana Schmier, MA; Joseph Crawley, MS; G. Richard Locke III, MD; Gregory de Lissovoy, PhD

Arch Intern Med. 2002;162:1361-1366.

Background  Over $6 billion per year is spent on prescription medication for gastroesophageal reflux disease (GERD). This study is an economic analysis of patients' willingness to pay for a prescription medication that offers complete relief of GERD symptoms.

Methods  The study was a cross-sectional, nonrandomized design recruiting patients from 5 clinical sites. A computer-administered discrete-choice questionnaire was used to explore patients' willingness to pay for various attributes (time to relief, amount of relief, side effects, and out-of-pocket cost) associated with GERD treatment. Patients chose between 2 different combinations of attributes by indicating which scenario they preferred. Data were gathered on health status, health-related quality of life, and sociodemographic characteristics.

Results  Two hundred five patients completed the discrete-choice questionnaire with a consistency rate of 99.5%. All attributes were relevant to patient decision making. Respondents were willing to pay up to $182 to obtain complete relief in a short period of time without side effects. Patients with less severe GERD symptoms were willing to pay more to avoid side effects ($58.25 vs $38.43). Older patients were less willing to pay for better relief than younger patients.

Conclusions  Results demonstrate that patients are willing to pay more per month for a medication that provides more complete and faster relief from GERD symptoms. This information can guide clinicians and formulary committees in evaluating optimal treatment for GERD.

From MEDTAP International, Bethesda, Md (Drs Kleinman and de Lissovoy and Ms Schmier); the Health Economics Research Center, University of Oxford, Oxford, England (Ms McIntosh); the Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland (Dr Ryan); AstraZeneca LP, Wayne, Pa (Mr Crawley); and the Mayo Clinic, Rochester, Minn (Dr Locke).

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