Patients Willingness to Contribute to Cost of Novel Implants in Total Joint Arthroplasty- “The Canadian Experience”

As health care organizations in North America adapt to more accountable financial models, it is becoming important to assess how patients value new technologies and their willingness to contribute to their cost. In Canada, healthcare is covered by a provincial health insurance program where patients do not directly participate in their costs for acute care. The aim of this study is to assess the willingness of Canadian patients to contribute to total joint arthroplasty implant costs. Our hypothesis is that patients would be willing to contribute, in a form of a co-payment, to the price of their implants in order to have access to new technologies. Our cohort included 115 patients in Ontario who were administered our questionnaire. The questionnaire featured a “standard” implant describing its longevity and risk of complications. We asked if participants would be willing to contribute to the cost of 3 novel implants with proposed differing longevity and risk of complications compared to the “standard implant”. Up to 62% of patients were willing to contribute a co-payment to increase their implant’s longevity. Willingness to pay decreased to 40% with increased risk of complications. Forty percent were willing to pay for a decreased risk of complications. Patients with higher education level and higher annual income were more likely to be willing to contribute to the cost of a novel implant with a proposed higher longevity or lower complication rates. This study demonstrated that up to 62% of our sample in Ontario are willing to share the costs of a novel total joint replacement implant. In comparison, a similar study showed that 26-45% of patients in the United States were willing to share costs of a novel implant. Willingness to pay was associated with the proposed implant benefits and certain patient characteristics. Our study shows that a high rate of Canadian patients is willing to co-pay to have access to new technologies.