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Preferences for prevention programs against chronic disease: does expected cause of death matter?

Authors
Publisher
University Of Oslo
Publication Date
Keywords
  • Vdp:806
Disciplines
  • Design
  • Economics
  • Mathematics
  • Medicine
  • Pharmacology

Abstract

Western countries devote significant resources to prevention of chronic illnesses, particularly cardiovascular disease (CVD). Consequently, life expectancy increases but deaths from other causes, such as cancer, also rise. Preferences for additional longevity later in life may be sensitive to expected cause of death, but this factor is typically ignored in economic evaluations of chronic disease prevention programs. We use current Norwegian mortality date to estimate life expectancy gains and changed distributions of cause of death associated with CVD and cancer prevention programs. For realistic levels of risk reduction, prevention programs against CVD and cancer increase longevity by 6 and 4 months, respectively. We survey a random sample of 2700 Norwegians, ages 40– 67, to examine preferences for prevention programs against CVD and cancer when individuals are informed about expected increases in life expectancy and resulting changes in the distribution of cause of death in the population. The survey is randomized for named vs. unnamed disease (CVD/cancer vs. Condition X/Y), medical vs. life-style interventions, and individual vs. societal perspective. A pilot study improved the design of the final survey. Results show little evidence that a desire for an “easy” death influenced respondents’ willingness to participate in a CVD prevention program; respondents accepted the offer of both CVD and cancer prevention at similar rates of 61%. Participation decisions were influenced by framing: more were willing to accept intervention if the disease was named and if treatment involved life-style changes rather than pharmaceutical treatment. Willingness-to-pay for prevention was low, with only 26% of the full sample agreeing to pay 150 NOK per month for CVD prevention, and 28% willing to pay for cancer prevention.

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