Purpose: Previous work in the general public has shown that African Americans report substantially lower willingness to pay (WTP) for improvements in knee osteoarthritis (OA) pain than do Whites; with Hispanics similar to Whites. This research examines whether the same patterns hold for patients with OA.

Methods: We sampled equal numbers of Whites, Hispanics and African Americans from patients being treated for knee osteoarthritis (OA) (N=198) in Houston, Texas. Face-to-face interviews were used to collect demographic and willingness to pay data. Participants were asked what amount of money they would be willing to pay to attain perfect health from the following three scenarios: their own current health, moderately painful osteoarthritis of the knee (MOA), and extremely painful and debilitating osteoarthritis of the knee (SOA).

Results: WTP as a percentage of income for each of the 3 scenarios was highest for Hispanics, intermediate for African Americans, and lowest for Whites (e.g., 40.8%, 30.4%, and 15.8% for MOA, respectively). Mean WTP showed the same pattern. In univariate regressions with WTP as a percentage of income, Hispanics had significantly higher WTP than did Whites for all three scenarios, and Blacks had significantly higher WTP for the MOA scenario. However, in multivariate regressions of log of WTP, controlling for income, age, gender, education and presence of insurance, no racial/ethnic variables were significant. Women had significantly lower WTP in all scenarios. Surprisingly, income level was not significantly associated with log WTP. Results were similar using non-logged WTP, although Hispanics were borderline significant.

Conclusions: The results found here stand in stark contrast to previous general public data from this project. In the public data, we found that WTP as a percentage of income was 26.4% for Hispanics, 16.7% for African Americans, and 32.9% for Whites for MOA scenario; and the finding that African Americans had significantly lower WTP for all scenarios, whereas Hispanics were similar to Whites, was extremely robust. Here, we find Whites having by far the lowest WTP. We find little differences between African Americans and Whites, and Hispanics have higher WTP (although not always significantly). Our findings provide evidence of shifts in preferences once a disease is acquired, and further that these shifts may vary in direction by racial/ethnic group.