Exploring willingness to pay out-of-pocket for genetic testing among ovarian cancer patients in Malaysia, a middle-income country in Asia
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Our previous study demonstrated that training oncologists to provide genetic counselling for ovarian cancer patients in Malaysia, an upper-middle-income Asian country, increased uptake of genetic testing to 80% when the test was free under research. However, in practice, genetic tests are unlikely to be provided for free in low-and-middle-income countries. In this study, we explored the willingness to pay (WTP) for genetic testing among ovarian cancer patients in Malaysia. METHODS: In this multi-center study, ovarian patients without prior genetic counselling were administered questionnaires on WTP (a contingent valuation exercise), facilitators and barriers to genetic counselling, and followed up for at least 6 months. We estimated the WTP value and explored factors associated with being willing to pay using logistic regression. RESULTS: Of 100 sequential patients recruited, 58% stated WTP for genetic testing at median of MYR1,000 (interquartile range=MYR1,125). Older participants were less likely to be willing to pay (odds ratio=0.95; 95% confidence interval=0.91-0.99). Reasons for being unwilling to pay included affordability (71%), belief that it should be paid by government or insurance (19%) and preference not to know their genetic status (14%). At the end of follow-up (mean 5±17 months), 17% took the test at full price. CONCLUSION: In this exploratory study, stated WTP for genetic testing was high but only at a reduced price. At follow-up, only a minority of patients paid the full price. A co-payment framework or subsidy scheme may be needed to reduce the significant cost barriers to genetic testing in Malaysia.
Source: Journal of Gynecologic Oncology
Authors: Heamanthaa Padmanabhan, Ka Keat Lim, Nur Tiara Hassan, Nor Syuhada Ahmad Bashah, Yong-Quan Lee, Joanna Lim, Ik Hui Teo, Yogeeta Gunasagran, Rubandra Kumaar Kalimuthu, Jamil Omar, Mohd Norazam Mohd Abas, Vickneswaren Thever Ramasamy, Chee Meng Yong, Mohamad Faiz Mohamed Jamli, Wee Wee Sim, Ahmad Muzamir Ahmad Mustafa, Nor Huda Mat Ali, Ismail Aliyas, Keng Joo Lim, Meow Keong Thong, Yin Ling Woo, Asrul Akmal Shafie, Soo-Hwang Teo, Sook-Yee Yoon
Institutions: Cancer Research Malaysia, Queen Mary University of London, King's College London, University Malaya Medical Centre, National Cancer Institute, Hospital Tuanku Ja’afar, Sarawak General Hospital, Hospital Tengku Ampuan Afzan, Hospital Sultanah Bahiyah, University of Malaya, Universiti Tunku Abdul Rahman Sungai Long Campus, Universiti Tunku Abdul Rahman, Universiti Sains Malaysia
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: diamond
Funder: Yayasan Sime Darby
OpenAlex ID: W4416270605