IDEAS home Printed from https://ideas.repec.org/a/wly/riskan/v29y2009i1p121-136.html
   My bibliography  Save this article

Are Adult Patients More Tolerant of Treatment Risks Than Parents of Juvenile Patients?

Author

Listed:
  • F. Reed Johnson
  • Semra Özdemir
  • Carol Mansfield
  • Steven Hass
  • Corey A. Siegel
  • Bruce E. Sands

Abstract

Understanding patient‐specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit‐risk trade‐off preferences for hypothetical treatments with varying efficacy and risk levels using a stated‐choice (SC) survey. We derive estimates of “maximum acceptable risk” (MAR) that can help decisionmakers identify welfare‐enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment‐related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit‐risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.

Suggested Citation

  • F. Reed Johnson & Semra Özdemir & Carol Mansfield & Steven Hass & Corey A. Siegel & Bruce E. Sands, 2009. "Are Adult Patients More Tolerant of Treatment Risks Than Parents of Juvenile Patients?," Risk Analysis, John Wiley & Sons, vol. 29(1), pages 121-136, January.
    • Handle: RePEc:wly:riskan:v:29:y:2009:i:1:p:121-136
    DOI: 10.1111/j.1539-6924.2008.01135.x
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/j.1539-6924.2008.01135.x
    Download Restriction: no
    File URL: https://libkey.io/10.1111/j.1539-6924.2008.01135.x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Krupnick, Alan & Alberini, Anna & Cropper, Maureen & Simon, Nathalie & O'Brien, Bernie & Goeree, Ron & Heintzelman, Martin, 2002. "Age, Health and the Willingness to Pay for Mortality Risk Reductions: A Contingent Valuation Survey of Ontario Residents," Journal of Risk and Uncertainty, Springer, vol. 24(2), pages 161-186, March.
    2. Mark Dickie, 2005. "Parental Behavior and the Value of Children's Health: A Health Production Approach," Southern Economic Journal, John Wiley & Sons, vol. 71(4), pages 855-872, April.
    3. Dickie, Mark & Messman, Victoria L., 2004. "Parental altruism and the value of avoiding acute illness: are kids worth more than parents?," Journal of Environmental Economics and Management, Elsevier, vol. 48(3), pages 1146-1174, November.
    4. F. Reed Johnson & Kristy E. Mathews, 2001. "Sources and Effects of Utility-Theoretic Inconsistency in Stated-Preference Surveys," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 83(5), pages 1328-1333.
    5. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304.
    6. Paul Clay Sorum, 1999. "Measuring Patient Preferences by Willingness to Pay to Avoid," Medical Decision Making, , vol. 19(1), pages 27-37, January.
    7. Smith, V Kerry & Desvousges, William H. & Fisher, Ann & Johnson, F. Reed, 1988. "Learning about Radon's Risk," Journal of Risk and Uncertainty, Springer, vol. 1(2), pages 233-258, June.
    8. David Revelt & Kenneth Train, 1998. "Mixed Logit With Repeated Choices: Households' Choices Of Appliance Efficiency Level," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 647-657, November.
    9. Kip Viscusi, W. & Magat, Wesley A. & Huber, Joel, 1991. "Pricing environmental health risks: survey assessments of risk-risk and risk-dollar trade-offs for chronic bronchitis," Journal of Environmental Economics and Management, Elsevier, vol. 21(1), pages 32-51, July.
    10. Ian J. Bateman & Richard T. Carson & Brett Day & Michael Hanemann & Nick Hanley & Tannis Hett & Michael Jones-Lee & Graham Loomes, 2002. "Economic Valuation with Stated Preference Techniques," Books, Edward Elgar Publishing, number 2639.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Seda Erdem & Dan Rigby, 2013. "Investigating Heterogeneity in the Characterization of Risks Using Best Worst Scaling," Risk Analysis, John Wiley & Sons, vol. 33(9), pages 1728-1748, September.
    2. Mehdi Najafzadeh & Sebastian Schneeweiss & Niteesh K. Choudhry & Jerry Avorn & Joshua J. Gagne, 2019. "General Population vs. Patient Preferences in Anticoagulant Therapy: A Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(2), pages 235-246, April.
    3. Tianjun Feng & L. Robin Keller & Liangyan Wang & Yitong Wang, 2010. "Product Quality Risk Perceptions and Decisions: Contaminated Pet Food and Lead‐Painted Toys," Risk Analysis, John Wiley & Sons, vol. 30(10), pages 1572-1589, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Longo, Alberto & Markandya, Anil & Petrucci, Marta, 2008. "The internalization of externalities in the production of electricity: Willingness to pay for the attributes of a policy for renewable energy," Ecological Economics, Elsevier, vol. 67(1), pages 140-152, August.
    2. Veisten, Knut & Flügel, Stefan & Rizzi, Luis I. & Ortúzar, Juan de Dios & Elvik, Rune, 2013. "Valuing casualty risk reductions from estimated baseline risk," Research in Transportation Economics, Elsevier, vol. 43(1), pages 50-61.
    3. Soliño, Mario & Farizo, Begoña A. & Vázquez, María X. & Prada, Albino, 2012. "Generating electricity with forest biomass: Consistency and payment timeframe effects in choice experiments," Energy Policy, Elsevier, vol. 41(C), pages 798-806.
    4. Stefania Troiano & Daniel Vecchiato & Francesco Marangon & Tiziano Tempesta & Federico Nassivera, 2019. "Households’ Preferences for a New ‘Climate-Friendly’ Heating System: Does Contribution to Reducing Greenhouse Gases Matter?," Energies, MDPI, vol. 12(13), pages 1-19, July.
    5. Richard T. Carson, 2011. "Contingent Valuation," Books, Edward Elgar Publishing, number 2489.
    6. Contu, Davide & Strazzera, Elisabetta & Mourato, Susana, 2016. "Modeling individual preferences for energy sources: The case of IV generation nuclear energy in Italy," Ecological Economics, Elsevier, vol. 127(C), pages 37-58.
    7. Hoyos, David, 2010. "The state of the art of environmental valuation with discrete choice experiments," Ecological Economics, Elsevier, vol. 69(8), pages 1595-1603, June.
    8. Naghmeh Niroomand & Glenn P. Jenkins, 2015. "Estimating the Value of Life, Injury, and Travel Time Saved Using a Stated Preference Framework," Development Discussion Papers 2015-08, JDI Executive Programs.
    9. Bruno Lanz & Allan Provins, 2013. "Valuing Local Environmental Amenity with Discrete Choice Experiments: Spatial Scope Sensitivity and Heterogeneous Marginal Utility of Income," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 56(1), pages 105-130, September.
    10. Veronesi, Marcella & Chawla, Fabienne & Maurer, Max & Lienert, Judit, 2014. "Climate change and the willingness to pay to reduce ecological and health risks from wastewater flooding in urban centers and the environment," Ecological Economics, Elsevier, vol. 98(C), pages 1-10.
    11. Hammitt, James K. & Haninger, Kevin, 2017. "Valuing nonfatal health risk as a function of illness severity and duration: Benefit transfer using QALYs," Journal of Environmental Economics and Management, Elsevier, vol. 82(C), pages 17-38.
    12. Zhang, Haifeng & Kono, Hiroichi & Kubota, Satoko & Wang, Jun, 2015. "Farmers’ Willingness to Pay for a Porcine Reproductive and Respiratory Syndrome (PRRS) Vaccine in Thua Thien Hue Province, Vietnam," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 18(2), pages 1-14, May.
    13. Miller, Sini & Tait, Peter & Saunders, Caroline, 2015. "Estimating indigenous cultural values of freshwater: A choice experiment approach to Māori values in New Zealand," Ecological Economics, Elsevier, vol. 118(C), pages 207-214.
    14. Bakhtiari, Fatemeh & Jacobsen, Jette Bredahl & Thorsen, Bo Jellesmark & Lundhede, Thomas Hedemark & Strange, Niels & Boman, Mattias, 2018. "Disentangling Distance and Country Effects on the Value of Conservation across National Borders," Ecological Economics, Elsevier, vol. 147(C), pages 11-20.
    15. Hoyos Ramos, David, 2010. "Using discrete choice experiments for environmental valuation," BILTOKI 1134-8984, Universidad del País Vasco - Departamento de Economía Aplicada III (Econometría y Estadística).
    16. Otieno, D., 2018. "Consumer Willingness to Pay for Fair Trade Attributes of Goat Meat in Kenya," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 277156, International Association of Agricultural Economists.
    17. Robert J. Johnston & Kevin J. Boyle & Wiktor (Vic) Adamowicz & Jeff Bennett & Roy Brouwer & Trudy Ann Cameron & W. Michael Hanemann & Nick Hanley & Mandy Ryan & Riccardo Scarpa & Roger Tourangeau & Ch, 2017. "Contemporary Guidance for Stated Preference Studies," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 319-405.
    18. Martínez-Jauregui, María & Herruzo, A. Casimiro & Campos, Pablo & Soliño, Mario, 2016. "Shedding light on the self-consumption value of recreational hunting in European Mediterranean forests," Forest Policy and Economics, Elsevier, vol. 69(C), pages 83-89.
    19. Ortega, David L. & Wang, H. Holly & Wu, Laping & Hong, Soo Jeong, 2015. "Retail channel and consumer demand for food quality in China," China Economic Review, Elsevier, vol. 36(C), pages 359-366.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:riskan:v:29:y:2009:i:1:p:121-136. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1539-6924 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.