Abstract
Introduction: The proliferation of health savings accounts has empowered patients to participate in medical decisions through a direct financial incentive. Using conjoint analysis we examined how much extra patients with a health savings account would be willing to pay for magnetic resonance imaging-transrectal ultrasound fusion guided prostate biopsy over transrectal ultrasound guided prostate biopsy. Methods: We enrolled men who were 55 to 70 years old from a general urology clinic. We performed a literature review, distributed surveys and conducted semi-structured interviews to develop and rank attributes commonly used to compare magnetic resonance-ultrasound to transrectal ultrasound guided prostate biopsy. Using conjoint surveys we asked participants to select their preferred choice between 2 hypothetical biopsy interventions with differing levels of the attributes and cost. Results of the conjoint surveys were analyzed using a multinomial probit model. We performed a sensitivity analysis to assess the stability of our results after adjusting for age, history of prostate cancer, race, education, marital status, income and Zip Code of residence. Results: Patients were willing to pay $1,598 more for a biopsy intervention with increased sensitivity to detect all cancer from 43% to 51% and $2,034 more for a negative predictive value improvement from 70% to 90%. Patients were not willing to pay extra for an intervention with improved sensitivity to detect high risk cancer alone. These estimates did not change with our sensitivity analysis. Conclusions: Our findings suggest that patients are willing to pay approximately $1,500 to $2,000 from a health savings account for a biopsy intervention with a benefit profile similar to that of magnetic resonance-ultrasound guided prostate biopsy.
Original language | English (US) |
---|---|
Pages (from-to) | 85-92 |
Number of pages | 8 |
Journal | Urology Practice |
Volume | 5 |
Issue number | 2 |
DOIs | |
State | Published - Mar 2018 |
Externally published | Yes |
Keywords
- biopsy
- cost-benefit analysis
- diagnostic imaging
- patient preference
- prostate
ASJC Scopus subject areas
- Urology