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J Am Acad Dermatol. 2008 Sep;59(3):439-47. doi: 10.1016/j.jaad.2008.05.032. Epub 2008 Jul 17.

Willingness-to-pay stated preferences for 8 health-related quality-of-life domains in psoriasis: a pilot study.

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  • 1Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.



Psoriasis is a chronic skin condition that has a major impact on health-related quality of life (QOL). We evaluated health-related QOL via willingness to pay and a ranking task for 8 domains of health relevant to psoriasis: intimacy, physical comfort, self-care, ability to work or volunteer, ability to concentrate, emotional health, social comfort, and ability to sleep.


The goals of the study were to pilot test a new method to measure QOL impact in psoriasis and identify the areas of life most affected by psoriasis.


Forty participants with a history of psoriasis were interviewed in a face-to-face format. First, participants were asked to rank the 8 domains of health we were investigating. Second, patients were asked how much money they would be willing to pay for a hypothetical cure for each domain of health. Responses in US dollars were interpreted as strength of preference rather than absolute monetary values.


About half of the patients in the sample (48%) were female, 60% had a college degree or further education, and 38% had an income level over $45,000/y. Physical comfort, social comfort, and emotional health were highly ranked by more than 75% of respondents. Ability to concentrate was least likely to be affected by psoriasis with just a quarter (25.7%) of respondents ranking this domain as important. The median amount patients were willing to pay for a hypothetical cure of psoriasis specific to a particular domain was highest for physical comfort ($2000, 25th quartile = $500, 75th quartile = $5500) and emotional health ($2000, 25th quartile = $250, 75th quartile = $5000), and lowest for ability to sleep ($625, 25th quartile = $50, 75th quartile = $5000).


The sample size is modest for this pilot study. Willingness to pay as a method of eliciting stated preferences for qualitative aspects of health may be influenced by individual perception of money.


This study successfully pilot tested a willingness-to-pay method and a ranking task to measure the relative severity of 8 domains of health-related QOL and found that physical comfort, social comfort, and emotional health were the domains of health most affected by psoriasis.

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