America

America

Francisco Perez-Arce, Jeremy Burke, Lila Rabinovich, Quanwu Zhang, Amir Abbas Tahami Monfared, Soeren Mattke

Journal paper

The Journal of Prevention of Alzheimer

2025

Objectives To estimate Americans’ willingness-to-pay (WTP) for universal access to a disease-modifying Alzheimer's disease (AD) treatment with a discrete choice experiment in a nationally representative sample. As part of this experiment, we examined whether providing information about the higher disease burden among minorities and persons of lower socioeconomic status (SES) changes WTP. Methods We conducted an information experiment using the nationally representative Understanding America Study (UAS) panel. Participants were provided with general information about AD and a hypothetical treatment that reduces disease progression by 30 %. Two-thirds of the sample were randomized to receive additional information about the higher prevalence of Alzheimer's among either lower SES groups or racial/ethnic minorities. We measured participants' WTP for making the treatment nationally available as a fixed annual fee and income-proportionate fee. Differences in WTP between those exposed to the additional information and those who were not provide the societal valuation of the equity-enhancing effects of the AD treatment. Results Average valuations were $252, $260 and $247 per year, and 0.59 %, 0.59 % and 0.61 % of earned income, for the control, race/ethnicity and SES frames, respectively—all statistically indistinguishable. These average results imply that Americans would be willing to pay $33.7 billion based on the fixed fee and $51.4 billion based on the income-related charge for universal access to an AD treatment annually, but their valuation does not further increase when informed about equity considerations. Conclusions While Americans value universal access to an AD treatment highly, health equity considerations did not significantly alter respondents’ WTP. Keywords: Alzheimer's disease; Disease modifying treatment; Information experiment; Health equity; Dementia; Economic evaluation