Does Insurance Value in Metastatic Breast Cancer Vary by Age Testing for Variation in Willingness to Pay for Novel Treatments Among Women in the US?
Author(s)
Jaehong Kim, PhD1, Maria Jakobsson, PhD2, Brett Hauber, PhD3, Justin Doan, MPH, MSc, DrPH4, Beata Korytowsky, MA5, Jason Shafrin, PhD6.
1FTI Consulting, Center for Healthcare Economics and Policy, Atlanta, GA, USA, 2Pfizer, Stockholm, Sweden, 3Pfizer, New York, NY, USA, 4Pfizer, Lake Mary, FL, USA, 5Pfizer Inc, New York, NY, USA, 6FTI Consulting, Los Angeles, CA, USA.
1FTI Consulting, Center for Healthcare Economics and Policy, Atlanta, GA, USA, 2Pfizer, Stockholm, Sweden, 3Pfizer, New York, NY, USA, 4Pfizer, Lake Mary, FL, USA, 5Pfizer Inc, New York, NY, USA, 6FTI Consulting, Los Angeles, CA, USA.
OBJECTIVES: This study aimed to quantify the insurance value of innovative treatments for HR+/HER2- metastatic breast cancer (mBC) and explore how this value varies across different age groups. Insurance value represents the premium individuals are willing to pay for reducing uncertainty in health outcomes, beyond the value of expected health gains.
METHODS: An online survey was administered to US women without cancer in three age groups (21-39, 40-64, and ≥65 years) to assess their willingness to pay (WTP) for insurance coverage of a new mBC treatment offering improved survival over the standard-of-care (SoC) (3-year survival rate: 65% vs. 50%). A multiple random staircase design identified each respondent’s indifference point between the insurance covering only SoC at no cost and a plan covering a novel, median survival-improving treatment at an added premium. Insurance value was calculated as the difference between the WTP for coverage and the risk-neutral value of health gains from the novel treatment. Risk-neutral value was calculated using the age-specific annual incidence of mBC and the economic value of QALYs gained. One-way ANOVA tested variation in insurance value by age group
RESULTS: Among the n=306 respondents, 84.6% (95% CI: 80.1%-88.5%), were risk averse and preferred generous coverage of the novel treatment for mBC. Average monthly WTP for additional coverage was $4.17 (vs. $1 for risk neutral), $30.41 (vs. $9) and $59.07 (vs. $18) for respondents aged 21-39, 40-64 and ≥65 years, respectively. Insurance value accounted for 70.1% of total WTP, with some differences across age groups (76.0%, 70.4%, and 69.5%, respectively, p=0.0495)
CONCLUSIONS: This study demonstrates the significant insurance value that individuals place on access to innovative mBC treatments, highlighting the importance of considering this value in healthcare decision-making. Age-related differences in insurance value as a proportion of total WTP were relatively small.
METHODS: An online survey was administered to US women without cancer in three age groups (21-39, 40-64, and ≥65 years) to assess their willingness to pay (WTP) for insurance coverage of a new mBC treatment offering improved survival over the standard-of-care (SoC) (3-year survival rate: 65% vs. 50%). A multiple random staircase design identified each respondent’s indifference point between the insurance covering only SoC at no cost and a plan covering a novel, median survival-improving treatment at an added premium. Insurance value was calculated as the difference between the WTP for coverage and the risk-neutral value of health gains from the novel treatment. Risk-neutral value was calculated using the age-specific annual incidence of mBC and the economic value of QALYs gained. One-way ANOVA tested variation in insurance value by age group
RESULTS: Among the n=306 respondents, 84.6% (95% CI: 80.1%-88.5%), were risk averse and preferred generous coverage of the novel treatment for mBC. Average monthly WTP for additional coverage was $4.17 (vs. $1 for risk neutral), $30.41 (vs. $9) and $59.07 (vs. $18) for respondents aged 21-39, 40-64 and ≥65 years, respectively. Insurance value accounted for 70.1% of total WTP, with some differences across age groups (76.0%, 70.4%, and 69.5%, respectively, p=0.0495)
CONCLUSIONS: This study demonstrates the significant insurance value that individuals place on access to innovative mBC treatments, highlighting the importance of considering this value in healthcare decision-making. Age-related differences in insurance value as a proportion of total WTP were relatively small.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE341
Topic
Economic Evaluation, Health Technology Assessment, Patient-Centered Research
Topic Subcategory
Novel & Social Elements of Value
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology