Willingness-to-Pay and Benefit–Cost Analysis of Botulinum Toxin for the Treatment of Rosacea in China: Findings from a Web-Based Survey

PURPOSE: Botulinum toxin (BTX) is a new treatment approach primarily aimed at relieving flushing and erythema for rosacea, but it is expensive and lacks economic benefit evaluation studies.This study aimed to investigate willingness-to-pay (WTP) of BTX treatment and conduct benefit–cost analysis (BCA) to assess if BTX treatment for rosacea is recommendable from a viewpoint of economics in China. METHODS: WTP of BTX treatment in rosacea and information of sociodemographic and clinical characteristics were inquired via an online questionnaire among the Chinese rosacea patients. The WTP was inquired by photos of three cases with different severities of rosacea before and after BTX treatment. The benefit–cost ratio (BCR) was calculated by dividing WTP by cost. Factors associated with WTP were identified using logistic regression models. RESULTS: The average costs of BTX treatment were USD410.09. The mean WTP for Case 1, Case 2, and Case 3 was USD295.53, 307.91, and 311.78, respectively (p<0.05 for Case 1 vs Case 3). 44.31% to 47.52% of Chinese rosacea patients were willing to pay for the BTX treatment. The BCRs were 0.72, 0.75, and 0.76 for Case 1, Case 2, and Case 3, respectively. A positive correlation between WTP and visiting frequency in the past year (OR=1.181–1.200, p=0.015–0.032, for Cases 1 and 2) or Dermatology Life Quality Index (DLQI) score (OR=2.022–2.266, all p<0.01) was observed, but duration (OR=0.521–0.564, p<0.05, for Cases 1 and 2) of rosacea was negatively correlated with WTP. CONCLUSION: For rosacea patients with poor quality of life, and those with high visiting frequency, BTX should be regarded as a recommendable new treatment in China.