Preferences and Willingness to Pay for Herpes Zoster Vaccination Among Chinese Adults: Discrete Choice Experiment

Abstract

Background:The incidence of herpes zoster (HZ) is rapidly increasing that cause both clinical and economic burden in China. Very little is known about Chinese residents' HZ vaccine preferences and willingness to pay (WTP) for each vaccination attribute. Objective:We aimed to elicit preferences of Chinese urban adults (aged ? 25 years) regarding HZ vaccination programs and to calculate WTP for each vaccination attribute. Methods:In our study, we interviewed 2,864 residents in nine cities in China. A discrete choice experiment (DCE) was conducted to investigate the residents' preferences for HZ vaccination and to predict the uptake rate for different vaccine scenarios. A mixed logit model was used to estimate the preferences and WTP for each attribute. Seven attributes with different levels were included in the experiment and we divided the coefficients of other attributes by the coefficient of price to measure WTP. Results:The vaccine effectiveness, protection duration, risk of side effects, place of origin and cost were proved to influence Chinese adults' preferences for HZ vaccination. Effectiveness of the HZ vaccine was the attribute that had the most predominant impact on residents' preferences, followed by protection duration. The residents were willing to pay CNY 974 to increase the vaccine effectiveness from 45% to 90% and they would barely pay for exchanging vaccination schedule from 2 doss to 1dose. It is suggested that the expected uptake could be promoted the most by 20.84% with an increase in protection rate from 45% to 90%. Conclusions:Chinese urban adults made trade-offs between vaccine effectiveness, protection duration, place of origin, sideeffects and cost of HZ vaccination. Vaccine effectiveness was the most important characteristic. The residents have the highest WTP to enhance the effectiveness of vaccines. To maximize HZ vaccine uptake, health authorities should promote vaccine effectiveness.