Monetary Risk Preferences and Demand for Preventative Treatment: A Discrete Choice Experiment Among Individuals at High Risk for Lung Cancer

Xiaoying Liu,1 Ian P Smith,2 Ellen M Janssen,3 Carol Mansfield4 1Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA; 2Interventional Oncology, Johnson & Johnson External Innovation, New Brunswick, NJ, USA; 3Global Epidemiology, Janssen Research and Development, Titusville, NJ, USA; 4RTI Health Solutions, Research Triangle Park, NC, USACorrespondence: Xiaoying Liu, Population Studies Center, 239 McNeil Building, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA, 19104-6298, USA, Email [email protected]: People’s risk preferences may differ depending on the domain in which someone is taking the risk, influencing their demand for innovative medical treatment with uncertain future benefits. This study aims to examine how monetary risk preferences are associated with health risk preferences for a hypothetical lung cancer preventative treatment (one that reduces the chance of getting lung cancer) and the demand for other preventative treatments or measures.Methods: A total of 803 individuals aged 50– 80 years at high risk of lung cancer completed a hypothetical investment exercise to measure monetary risk preference, as well as a discrete-choice experiment to measure health risk preference for lung cancer preventative treatment. They also answered questions about other preventative treatments or measures and screening tests they have taken.Results: On average, respondents were willing to invest $67.40 (SD= $31.20) out of $100 in the hypothetical investment exercise. Given the presented levels of benefits and side effects of hypothetical treatment, 50.2% of the participants favored lung cancer preventative treatment, 29.2% were undecided, while 20.7% disliked it. Compared to those not willing to invest any amount, those willing to invest higher amounts were less likely to fall into the no-treatment group (OR=0.171 (p< 0.001) to 0.335 (p=0.049), depending on the investment amount category). Additionally, individuals who expressed greater willingness to invest were also more likely to have previously received other forms of preventative healthcare (OR=1.008, p=0.025).Conclusion: Monetary risk preference is related with risk preferences in health and can predict demand for preventative treatments or measures.Plain Language Summary: Monetary risk preference measures one’s tendency to make a risky investmentMonetary risk preference is associated with preference for a hypothetical preventative therapy for lung cancerMore monetary risk averse, less willing to try an innovative treatment and receive other preventative healthcare.Keywords: risk aversion, risk perception, latent-class analysis, novel treatment