Factor associated with willingness to pay for prevention of cancer: a study of prostate cancer screening

Hiro Farabi; Najmeh Moradi; Aziz Ahmadzadeh; Seyed Mohammad Kazem Agamir; Abdolreza Mohammadi; Aziz Rezapour

doi:10.1186/s12962-023-00494-0

Factor associated with willingness to pay for prevention of cancer: a study of prostate cancer screening

Cost Eff Resour Alloc. 2023 Nov 21;21(1):89. doi: 10.1186/s12962-023-00494-0.

Authors

Hiro Farabi¹, Najmeh Moradi², Aziz Ahmadzadeh³, Seyed Mohammad Kazem Agamir⁴, Abdolreza Mohammadi⁴, Aziz Rezapour⁵

Affiliations

¹ Barts and the London Pragmatic Clinical Trials Unit, Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
² Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
³ Insurance Research Center (IRC), Tehran, Iran.
⁴ Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. rezapour.a@iums.ac.ir.

Abstract

Introduction: This study investigates Iranian men's willingness to pay (WTP) for prostate cancer (PCa) screening and influencing factor, along with the impact of information.

Method: We assessed preferences for prostate cancer screening in 771 Iranian men aged 40 and above using an internet-based questionnaire survey. Participants received basic and complementary information, and their willingness to pay was determined through a payment card approach. A Wilcoxon test assessed the impact of information. We also analyzed prostate cancer screening demand and employed Heckman's two-step model to evaluate factors influencing the willingness to pay. Additionally, reasons for unwillingness to pay were explored.

Results: Willingness to pay significantly decreased with complementary information relative to basic information (16.3$ vs 17.8$). Heckman model, using WTP based on basic information shows age, education, and monthly household expenditure positively influenced the decision to pay. In contrast, health status, expectations of remaining life and prostate problems history positively affect amount of WTP for PCa screening, and insurance coverage has a negative impact on it. Majority of respondents (91%) supported PCa screening, with 82% expressing a willingness to pay. Common reasons for not paying include seeing screening as a public good (43%), financial constraints (35%), and having insurance (20%). The screening demand is price-sensitive.

Conclusion: The basic mindset of Iranian men exaggerates the risk of prostate cancer. Reduced willingness to pay after receiving information reassures the reliability of their financial expectation. Taking into account the factors that influence PCa screening is essential for accurate planning and the successful implementation of this program.

Keywords: Contingent valuation; Factor associated; Prostate cancer; Screening; Willingness to pay.