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Wednesday, 18 October 2006


Robert M. Hamm, PhD, University of Oklahoma Health Sciences Center, Oklahoma City, OK

Purpose. Vaccines are available against High Risk Human Papillomavirus (HRHPV), the sexually transmitted infection that causes cervical cancer. Our study of women's reaction to diagnosis of HRHPV asked how much they would be willing to pay (WTP) for vaccination. The WTP question was of low quality (categorical, not disciplined by choice). Does it reflect attitude to vaccination, rather than estimate price? Relation of WTP to SES variables, vaccination attitudes, and stated likelihood of seeking the vaccine was determined, for women whose HRHPV test result was positive or negative. Methods. Women with ASC-US Pap smears were interviewed after receiving HPV DNA test results. HRHPV result (positive, negative) was from medical records. Computerized interview asked: HPV vaccination likelihood (4 categories, very unlikely to very likely); vaccination attitude (importance of vaccination against each of 4 types of disease, including STIs); WTP for HPV vaccine (0-25, 26-50, 51-75, 76-100, more than 100); and other questions. Analytic methods included multiple regression and structural equation modeling, using 1-4 for likelihood and the range midpoints for WTP. Results. Most of 112 HRHPV- and 158 HRHPV+ respondents were “Very Likely” to get an HRHPV vaccination, and would pay $0 to $25 for it. A positive test made them significantly more likely, and increased the average WTP. 20% of HRHPV+ women, compared to 9% of HRHPV-, would pay > $100 for vaccination. The mean WTP for those “very unlikely” to get HRHPV vaccination was $12, and it increased with each likelihood category to $53 for those “very likely”. WTP was not correlated with attitudes to vaccination for other diseases. Income was positively correlated with WTP and attitude to childhood vaccination, but negatively associated with HRHPV vaccination likelihood and attitude to vaccination against the other three disease types. In a structural equation model, vaccination likelihood was influenced by HRHPV status but not Income; WTP was influenced by HRHPV status, income, and vaccination likelihood. Conclusion. Although it lacks the discipline provided by choice, WTP for HRHPV vaccine, measured by selecting a range of prices, is related to stated likelihood of getting HRHPV vaccine and to income. It is not related to attitudes to vaccination for other diseases. Perhaps it reflects an attitude toward paying for HRHPV vaccine, rather than a valid price estimate.

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See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)