Comorbidities, quality of life and patients' willingness to pay for a cure for type 2 diabetes in Taiwan

SummaryObjectivesDiabetes is one of the leading causes of death in Taiwan. However, to date, no study has investigated the patient profile in this country. Therefore, this study aimed to analyse health condition, health-related quality of life and associated financial burden of people with diabetes in Taiwan.Study designA cross-sectional survey was conducted using face-to-face interviews with patients with diabetes aged 18 years and over from four hospitals in northern Taiwan. A hypothetical scenario was designed to ascertain subjects' willingness to pay for a cure for diabetes. Ethical approval and consent were obtained from the patients and hospital ethics boards.MethodsA double-bounded dichotomous contingent valuation method and maximum log-likelihood model were employed to evaluate the cost of the disease in Taiwan. Anchoring effect and regression validity were tested and performed for the analysis. EQ-5D was employed to assess patients' health-related quality of life.ResultsThe main comorbidities reported were hypertension (52.2%), cataract (34.3%) and loss of sight (24.3%). The total cost of disease borne by each patient with diabetes is US$3065.7 per year. The total cost of diabetes to society is approximately US$2.96 billion, equivalent to approximately 0.8% of the gross domestic product of Taiwan. The Bureau of National Health Insurance alleviates approximately one-third of the burden for patients.ConclusionsThe presence of specific comorbidities for patients with diabetes does not have a significant impact on their willingness to pay for a cure. However, body mass index, health-related quality of life and ability to decrease blood glucose level were significantly associated with willingness to pay. With ever-increasing health expenditures around the world, cost containment should start with preventive approaches. Health policies regarding the prevention of diabetes should focus on the promotion of life quality and fitness of the patients.