Measuring melasma patients' quality of life using willingness to pay and time trade-off methods in thai population

Abstract

BackgroundMelasma is a common hyperpigmentation disorder that has a significant effect on an individual's quality of life. However, there is no preference-based measurement that reflects quality of life in patients with melasma. The objective of this study was to assess the impact of melasma on quality of life by using a health status measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement - Willingness to Pay (WTP) and Time Trade-Off (TTO).MethodsA cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended the melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of the DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patients' quality of life.ResultsSeventy-seven (98.7%) patients were female with a mean age of 47.8 ± 7.9 years. The mean health utility based on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly correlated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective treatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP was significantly correlated with monthly personal income and the total DLQI score.ConclusionThe WTP method could be a useful tool with which to measure the quality of life of patients with melasma.

Cost and Utility Analysis of a Store-and-Forward Teledermatology Referral System

“…From baseline to the 9-month follow-up, the amount of time participants in the teledermatology group were willing to trade was approximately 7 months fewer than at baseline, and participants in the conventional referral group were willing to trade approximately 4 fewer months, with both values representing a gain in utility. Prior studies of various skin conditions 5,[14][15][16] have resulted in utility values similar to ours, although none included a teledermatology intervention. Using the time trade-off technique found to range from 0.64 for bullous disease to 1.0 for urticarial and cosmetic conditions, with most of the skin conditions resulting in utilities in a range similar to our results (0.91-0.99).…”

Patient‐assigned health utility values for controlled and uncontrolled pemphigus vulgaris and foliaceus

“…To put this in another way, patients were willing to trade 24% of their remaining hypothetical 10‐year life expectancy to be free from pemphigus. The relatively low utility values in pemphigus compared to other skin diseases reflect the large impact of PV and PF on the life of these patients . In other studies, patients with various chronic dermatological conditions valued their actual health as follows (mean values): hidradenitis suppurativa 0.63, systemic sclerosis 0.76, psoriasis 0.88, melasma 0.92, atopic dermatitis 0.93, port wine stains 0.95 and acne 0.96 .…”

“…The relatively low utility values in pemphigus compared to other skin diseases reflect the large impact of PV and PF on the life of these patients. [29][30][31][32][33][34][35][36][37] In other studies, patients with various chronic dermatological conditions valued their actual health as follows (mean values): hidradenitis suppurativa 0.63, 31 systemic sclerosis 0.76, 33,34 psoriasis 0.88, 32 melasma 0.92, 35 atopic dermatitis 0.93, 32 port wine stains 0.95 36 and acne 0.96. 37 However, results of these studies are not directly comparable to those of our study due to differences in the TTO methodologies, such as varying length of time frame in the TTO task.…”

“…Previously, a large number of studies in various diseases found no or at most modest correlation between disease severity measures and health utilities . Examples from the field of dermatology include Melasma Area Severity Index, Investigator's Static Global Assessment score in acne and Hurley staging in hidradenitis suppurativa . Evidence suggests that clinical variables may explain only a part of health utilities, while person‐related variables such as socioeconomic status, having children and attitudes towards death represent the major source of variation …”

“…38 Examples from the field of dermatology include Melasma Area Severity Index, Investigator's Static Global Assessment score in acne and Hurley staging in hidradenitis suppurativa. 31,35,37 Evidence suggests that clinical variables may explain only a part of health utilities, while person-related variables such as socioeconomic status, having children and attitudes towards death represent the major source of variation. Our results are in accordance with earlier studies assessing HRQoL and its predictors in patients with pemphigus by using EQ-5D, SF-36, WHOQOL-BREF, DLQI and Skindex-29.…”