Preferences and Willingness to Pay for Maintenance Inhalers Among Adults With Chronic Obstructive Pulmonary Disease in Thailand: A Discrete Choice Experiment
Author(s)
Thananan Rattanachotphanit, PhD1, Thanyaporn Kuagoolsirirot, PhD candidate2, Onanong Waleekhachonloet, PhD1, Supon Limwattananon, PhD3, Chulaporn Limwattananon, PhD4.
1Division of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand, 2Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand, 3International Health Policy Foundation, Bangkok, Thailand, 4Independent researcher, Khon Kaen, Thailand.
1Division of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand, 2Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand, 3International Health Policy Foundation, Bangkok, Thailand, 4Independent researcher, Khon Kaen, Thailand.
OBJECTIVES: New inhalers for chronic obstructive pulmonary disease (COPD) combine multiple drugs into a single device, reducing dosing frequency, enhancing ease of use, and improving treatment adherence. However, they come at a higher cost and are currently not included in Thailand’s universal health coverage benefit package. This study aimed to assess patient preference and willingness to pay (WTP) for key attributes of maintenance inhalers among COPD patients in Thailand.
METHODS: A discrete choice experiment (DCE) was conducted at outpatient clinics in hospitals across four regions in Thailand. Five attributes including ease of use, number of inhalers per day, dosing frequency, inspiratory effort, and monthly out-of-pocket payment were selected based on literature, patient focus groups, and clinician interviews. Patients with COPD aged 40-65 years were recruited through convenient sampling. A mixed logit regression model was used to analyze preferences and estimate WTP.
RESULTS: A total of 197 patients with COPD completed the DCE. The most valued attribute was ease of use with no mistakes (marginal utility 1.321, 95% CI 0.844, 1.797), followed by reducing the number of inhalers to one per day (marginal utility 1.180 (95% CI 0.764, 1.597). Patients were willing to pay US$15.7 per month (95% CI 12.1, 19.4) for an inhaler that minimized usage errors and US$14.0 per month (95% CI 10.9, 17.2) for reducing inhaler use to once per day.
CONCLUSIONS: Thai adults with COPD highly value maintenance inhaler that improve usability, particularly those that minimize usage errors and reducing the number of inhalers per day. Patients are willing to pay approximately US$15 for these improved features.
METHODS: A discrete choice experiment (DCE) was conducted at outpatient clinics in hospitals across four regions in Thailand. Five attributes including ease of use, number of inhalers per day, dosing frequency, inspiratory effort, and monthly out-of-pocket payment were selected based on literature, patient focus groups, and clinician interviews. Patients with COPD aged 40-65 years were recruited through convenient sampling. A mixed logit regression model was used to analyze preferences and estimate WTP.
RESULTS: A total of 197 patients with COPD completed the DCE. The most valued attribute was ease of use with no mistakes (marginal utility 1.321, 95% CI 0.844, 1.797), followed by reducing the number of inhalers to one per day (marginal utility 1.180 (95% CI 0.764, 1.597). Patients were willing to pay US$15.7 per month (95% CI 12.1, 19.4) for an inhaler that minimized usage errors and US$14.0 per month (95% CI 10.9, 17.2) for reducing inhaler use to once per day.
CONCLUSIONS: Thai adults with COPD highly value maintenance inhaler that improve usability, particularly those that minimize usage errors and reducing the number of inhalers per day. Patients are willing to pay approximately US$15 for these improved features.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD159
Topic Subcategory
Reproducibility & Replicability
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)