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One-third of patients would risk shorter life rather than take pill for CVD prevention
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In an Internet-based survey of 1,000 people, approximately one-third said they would risk a shorter life rather than take a daily pill for prevention of CVD.
The cross-sectional Internet-based survey was administered to 1,000 U.S. residents aged 30 years or older in March 2014. Of those, the mean age was 50 years, 59% were women, 63% were white, 28% had less than a college degree and 79% took at least one pill per day. For the purpose of this study, participants were instructed to assume that the pill had no side effects and no cost.
The main outcome was mean utility value for taking one pill per day using the time-tradeoff method. Using the time-tradeoff method, researchers reported that 70% of respondents were not willing to trade any amount of time to avoid taking a daily pill for CVD prevention. However, more than 8% were willing to trade as much as 2 years of life in exchange for not having to take a daily pill and approximately 21% were willing to trade between 1 week and 1 year of life. Mean utility was 0.99 (95% CI, 0.988-0.992).
“What we were really trying to measure is how much the act of taking a pill — obtaining it, remembering to take it and actually taking it — interferes with one’s quality of life,” Robert Hutchins, MD, MPH, resident physician in the department of medicine, division of general internal medicine at the University of California, San Francisco, said in a press release. “Even ignoring the side effects of pills, the act of having to take a daily pill can have a large effect on an individual’s quality of life. When you consider that many adults are on numerous pills, the effect is often magnified for that person.”
Using the standard gamble method, which assesses risk attitude, 62% of respondents were not willing to risk any chance of death to avoid taking a daily pill for CVD prevention, 13% would accept minimal risk for death to avoid taking the pill and 9% would accept a 10% chance of death. Mean utility was 0.991 (95% CI, 0.989-0.993).
Using the modified willingness-to-pay method, researchers reported that respondents were willing to pay an average of $1,445 to avoid taking a daily pill to prevent CVD, which translates to a mean utility of 0.994 (95% CI, 0.94-0.997). Twenty-one percent of respondents would pay $1,000 or more to avoid taking the pill, but 43% said they would not pay any amount.
“Knowing [the mean utility] value and the distribution of responses may be useful for researchers and policymakers evaluating preventive interventions for CVD that include taking pills, including the decision about taking aspirin or statins, and should be considered in addition to information about the decrements in utility from adverse outcomes such as gastrointestinal bleeding or myopathy,” Hutchins and colleagues wrote.
Disclosure: The researchers report no relevant financial disclosures.
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