Estimating the willingness-to-pay to avoid the consequences of foodborne illnesses: a discrete choice experiment

Assessment of consumer demographics and food safety risks associated with ready-to-eat (RTE) homemade foods purchased online in the UAE

In the UAE, female entrepreneurs, termed "Tajrat", sell a variety of homemade food products over online social media (OSM) platforms. Some of these food products are prepared and sold outside regulatory channels, with serious public health consequences. The study aimed to identify consumer demographics associated with purchasing of RTE, homemade food sold over in OSM platforms in the UAE and to assess the food quality by evaluating microbiological quality and fat percentage in RTE foods. A representative survey of the population of the UAE (n = 1303) was conducted, covering consumer demographics, frequency of purchase, and respondents' perception towards safety and nutritional value. 66 % of respondents were Emiratis, fifty percent of whom purchased RTE foods online. Moreover, 61 % of participants purchased from "Tajrat" via OSM as opposed to other sources. Convenience (47 %) and taste (41 %) were the main drivers for purchasing RTE homemade foods. Although 76 % of respondents have at least one member of their family considered vulnerable, the safety levels, quality, and nutritional value of such products did not carry the same significance. Microbiological analysis of 35 food samples purchased online from "Tajrat" was conducted. Listeria spp. was isolated from 22 % of the samples, 43 % showed positive Staphylococcus aureus, and 31 % of the samples had coliform bacteria. Total Fat Content of RTE homemade food samples ranged between 2.6 and 30 g/100 g which is considered high and can cause serious health issues if consumed frequently. Recommendations from this study will help policy makers and regulators in the UAE to develop and implement education strategies targeting homemade food handlers.

Societal preferences for funding orphan drugs in China: An application of the discrete choice experiment method

Objectives

To explore whether a societal preference for orphan drugs exists in Chinese general public and to quantitatively measure the personal trade-off between essential attributes of orphan drugs through a discrete choice experiment.

Methods

A labeled discrete choice experiment was employed to measure public preference. Six attributes (impact of diseases on life-years, impact of diseases on quality of life, availability of alternative drug treatments, annual cost per patient paid by medical insurance, expected increases in life-expectancy, and improvements to the quality of life) were identified through a literature review, experts' suggestions, and stakeholders' semi-structured interviews, then refined through a pre-survey. The current study used a D-efficient design to yield 27 choice sets divided into three blocks with nine questions containing the labeled treatment (either orphan drugs or common drugs). Information on sociodemographic characteristics and individual preferences was collected through a web-based questionnaire using convenience sampling. A mixed logit model was used to test societal preferences for orphan drugs over common drugs, while a binary logit model was used to measure the relative importance of each attribute in orphan drug access for the National Reimbursement Drug List and its willingness to pay.

Results

A total of 323 persons participated in this study. Respondents largely had indifferent attitudes toward orphan drugs and common drugs. The binary logit model results showed that 5 of the 6 attributes were significant, except for the availability of alternative drug treatments. The most impacted factor was the annual cost per patient paid by medical insurance (β = -1.734, odds ratio [OR] = 0.177). Among non-economic attributes, the impact of diseases on life-years-with no treatment, the patient will die in the prime of life (β = 0.523, OR = 1.688, willingness to pay = 301,895)-was most concerning, followed by significant improvements to the quality of life (β = 0.516, OR = 1.676, willingness to pay = 297,773).

Conclusion

The general public in China does not value rarity as a sufficient reason to justify special consideration in funding orphan drugs. When making orphan drug coverage decisions, the public prioritized the annual cost, disease severity, and drug effects.