Dissonance in the face of Alzheimer's disease breakthroughs: clinician and lay stakeholder acceptance, concerns and willingness to pay for emerging disease-modifying therapies.

Kinchin, I; Walsh, S; Dinh, R; Kapuwa, M; Kennelly, SP; Miller, A-M; Nolan, A; O'Dowd, S; O'Philbin, L; Timmons, S; Leroi, I

Dissonance in the face of Alzheimer's disease breakthroughs: clinician and lay stakeholder acceptance, concerns and willingness to pay for emerging disease-modifying therapies.

Kinchin, I

Walsh, S Dinh, R Kapuwa, M Kennelly, SP Miller, A-M Nolan, A O'Dowd, S O'Philbin, L Timmons, S Leroi, I

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Publisher:: CAMBRIDGE UNIV PRESS
Publication Type:: Journal Article
Citation:: Br J Psychiatry, 2024, 224, (6), pp. 230-236
Issue Date:: 2024-06

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Field	Value	Language
dc.contributor.author	Kinchin, I https://orcid.org/0000-0003-0133-2763
dc.contributor.author	Walsh, S
dc.contributor.author	Dinh, R
dc.contributor.author	Kapuwa, M
dc.contributor.author	Kennelly, SP
dc.contributor.author	Miller, A-M
dc.contributor.author	Nolan, A
dc.contributor.author	O'Dowd, S
dc.contributor.author	O'Philbin, L
dc.contributor.author	Timmons, S
dc.contributor.author	Leroi, I
dc.date.accessioned	2024-10-10T03:04:47Z
dc.date.available	2024-10-10T03:04:47Z
dc.date.issued	2024-06
dc.identifier.citation	Br J Psychiatry, 2024, 224, (6), pp. 230-236
dc.identifier.issn	0007-1250
dc.identifier.issn	1472-1465
dc.identifier.uri	http://hdl.handle.net/10453/181371
dc.description.abstract	BACKGROUND: Introducing new disease-modifying therapies (DMTs) for Alzheimer's disease demands a fundamental shift in diagnosis and care for most health systems around the world. Understanding the views of health professionals, potential patients, care partners and taxpayers is crucial for service planning and expectation management about these new therapies. AIMS: To investigate the public's and professionals' perspectives regarding (1) acceptability of new DMTs for Alzheimer's disease; (2) perceptions of risk/benefits; (3) the public's willingness to pay (WTP). METHOD: Informed by the 'theoretical framework of acceptability', we conducted two online surveys with 1000 members of the general public and 77 health professionals in Ireland. Descriptive and multivariate regression analyses examined factors associated with DMT acceptance and WTP. RESULTS: Healthcare professionals had a higher acceptance (65%) than the general public (48%). Professionals were more concerned about potential brain bleeds (70%) and efficacy (68%), while the public focused on accessibility and costs. Younger participants (18-24 years) displayed a higher WTP. Education and insurance affected WTP decisions. CONCLUSIONS: This study exposes complex attitudes toward emerging DMTs for Alzheimer's disease, challenging conventional wisdom in multiple dimensions. A surprising 25% of the public expressed aversion to these new treatments, despite society's deep-rooted fear of dementia in older age. Healthcare professionals displayed nuanced concerns, prioritising clinical effectiveness and potential brain complications. Intriguingly, younger, better-educated and privately insured individuals exhibited a greater WTP, foregrounding critical questions about healthcare equity. These multifaceted findings serve as a guidepost for healthcare strategists, policymakers and ethicists as we edge closer to integrating DMTs into Alzheimer's disease care.
dc.format	Print
dc.language	eng
dc.publisher	CAMBRIDGE UNIV PRESS
dc.relation.ispartof	Br J Psychiatry
dc.relation.isbasedon	10.1192/bjp.2024.24
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Psychiatry
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.classification	52 Psychology
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Ireland
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Adolescent
dc.subject.mesh	Young Adult
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Aged
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Health Personnel
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Health Personnel
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Ireland
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Humans
dc.subject.mesh	Alzheimer Disease
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Ireland
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Adolescent
dc.subject.mesh	Young Adult
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Aged
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Health Personnel
dc.title	Dissonance in the face of Alzheimer's disease breakthroughs: clinician and lay stakeholder acceptance, concerns and willingness to pay for emerging disease-modifying therapies.
dc.type	Journal Article
utslib.citation.volume	224
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Centre for Health Economics Research and Evaluation (CHERE)
pubs.organisational-group	University of Technology Sydney/UTS Groups/Centre for Health Economics Research and Evaluation (CHERE)/Centre for Health Economics Research and Evaluation (CHERE) Associate Member
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-10-10T03:04:46Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	224
utslib.citation.issue	6

Abstract:

BACKGROUND: Introducing new disease-modifying therapies (DMTs) for Alzheimer's disease demands a fundamental shift in diagnosis and care for most health systems around the world. Understanding the views of health professionals, potential patients, care partners and taxpayers is crucial for service planning and expectation management about these new therapies. AIMS: To investigate the public's and professionals' perspectives regarding (1) acceptability of new DMTs for Alzheimer's disease; (2) perceptions of risk/benefits; (3) the public's willingness to pay (WTP). METHOD: Informed by the 'theoretical framework of acceptability', we conducted two online surveys with 1000 members of the general public and 77 health professionals in Ireland. Descriptive and multivariate regression analyses examined factors associated with DMT acceptance and WTP. RESULTS: Healthcare professionals had a higher acceptance (65%) than the general public (48%). Professionals were more concerned about potential brain bleeds (70%) and efficacy (68%), while the public focused on accessibility and costs. Younger participants (18-24 years) displayed a higher WTP. Education and insurance affected WTP decisions. CONCLUSIONS: This study exposes complex attitudes toward emerging DMTs for Alzheimer's disease, challenging conventional wisdom in multiple dimensions. A surprising 25% of the public expressed aversion to these new treatments, despite society's deep-rooted fear of dementia in older age. Healthcare professionals displayed nuanced concerns, prioritising clinical effectiveness and potential brain complications. Intriguingly, younger, better-educated and privately insured individuals exhibited a greater WTP, foregrounding critical questions about healthcare equity. These multifaceted findings serve as a guidepost for healthcare strategists, policymakers and ethicists as we edge closer to integrating DMTs into Alzheimer's disease care.

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http://hdl.handle.net/10453/181371