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Randomized Controlled Trial
. 2019 Jan 9;19(1):6.
doi: 10.1186/s12911-018-0725-4.

Assigning value to preparation for prostate cancer decision making: a willingness to pay analysis

Leslie S Wilson  1 , Traci M Blonquist  2 , Fangxin Hong  2 , Barbara Halpenny  2 , Seth Wolpin  3 , Peter Chang  4 , Christopher P Filson  5 , Viraj A Master  5 , Martin G Sanda  5 , Gary W Chien  6 , Randy A Jones  7 , Tracey L Krupski  7 , Donna L Berry  8
Affiliations
Randomized Controlled Trial

Assigning value to preparation for prostate cancer decision making: a willingness to pay analysis

Leslie S Wilson et al. BMC Med Inform Decis Mak. .

Abstract

Background: The Personal Patient Profile-Prostate (P3P) is a web-based decision support system for men newly diagnosed with localized prostate cancer that has demonstrated efficacy in reducing decisional conflict. Our objective was to estimate willingness-to-pay (WTP) for men's decisional preparation activities.

Methods: In a multicenter, randomized trial of P3P, usual care group participants received typical preparation for decision making plus referral to publicly-available, educational websites. Intervention group participants received the same, plus online P3P educational media specific to the user's personal preferences and values, and a communication coaching component tailored to race\ethnicity, age and language. WTP data were collected one week after physician consultation. An iterative bidding direct contingent valuation survey format was used, randomly assigning participants to high or low starting values (SV). Tobit models were used to explore associations between SV-adjusted WTP and age, education, marital and work-status, insurance, decision-control preference and decision-making stage.

Results: Of 392 participants enrolled, 141 P3P and 107 usual care (UC) provided a WTP value. Men were willing to pay a median $25 (IQR $10-100) for P3P in addition to usual care preparation materials. In the final multivariable tobit regression model, SV, marital status, stage of decision making and income were significantly associated with WTP for P3P. Decision control preference was considered marginally significant (p = 0.11). Men were WTP a median $30 (IQR $10-$200) for usual care material alone. In the final multivariable model, SV, education, and stage of decision making were significantly associated with WTP in usual care.

Conclusion: WTP was similar for UC and for the addition of P3P to UC decision preparation. The WTP values were associated with demographic and preference variables. Findings can help focus decision support on future patients who would benefit most: those without strong support systems, at earlier stages of decision making, and open to a shared-decision style.

Trial registration: NCT NCT01844999 . Registered May 3, 2013.

Keywords: Decision aid; Prostate cancer; Shared decision making; Willingness to pay.

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Conflict of interest statement

Ethics approval and consent to participate

● Dana-Farber Cancer Institute Institutional Review Board (FWA0001121) - Protocol Number 12–363 (provided review for Beth Israel Deaconess Medical Center in Boston, University of Massachusetts Memorial Hospital in Worcester, and the community clinic in western New York);

● Emory University Institutional Review Board (FWA00005792) – Study Number IRB00068991 (provided review for Emory University Hospital-Tower and -Midtown, and Grady Memorial Hospital) and IRB00082282 (provided review for Atlanta Veterans Affairs Medical Center)

● Kaiser Permanente Southern California Institutional Review Board (FWA00002344) - Study Number 10111 (provided review for KPSC-Los Angeles and -Downey Medical Centers)

● University of Virginia Institutional Review Board for the Social and Behavioral Sciences (FWA00006183) - Project # 2011–0172-00 (provided review for University of Virginia Health System)

● University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects (FWA00000667) – UTHealth Protocol Number HSC-MS-13-0452/Harris Health System Protocol Number 13-09-0576 (provided review for Lyndon B Johnson Hospital)

Written informed consent was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that there are no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
WTP demand curve for the P3P intervention
See this image and copyright information in PMC

References

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