Willingness to pay for hepatitis B vaccination in Selangor, Malaysia: A cross-sectional household survey

PLoS One. 2019 Apr 9;14(4):e0215125. doi: 10.1371/journal.pone.0215125. eCollection 2019.

Abstract

Background: In Malaysia, one million individuals are estimated to be infected with the hepatitis B virus. A vaccine for infants has been compulsory since 1989, whereas those born before 1989 need to spend their own money to be vaccinated in private clinics or hospitals. The aim of this study was to investigate and ascertain the determinants of willingness to pay (WTP) for adult hepatitis B vaccine in Selangor, Malaysia.

Methods: In 2016, 728 households were selected through a stratified, two stage cluster sample and interviewed. Willingness to pay for hepatitis B vaccine was estimated using the Contingent Valuation Method, and factors affecting WTP were modelled with logit regression.

Results: We found that 273 (37.5%) of the households were willing to pay for hepatitis B vaccination. The mean and median of WTP was estimated at Ringgit Malaysia (RM)303 (approximately US$73) for the three dose series. The estimated WTP was significantly greater in those with higher levels of education, among Malays and Chinese (compared to others, predominantly Indians), and for those with greater perceived susceptibility to hepatitis B virus infection. Other factors-perceived severity, barriers, benefits and cues to action-were not significantly associated with WTP for adult hepatitis B vaccination.

Conclusion: Additional resources are needed to cover the households that are not willing to pay for hepatitis B vaccination. More awareness (particularly in regards to hepatitis B virus susceptibility) could change the national perception towards self-paid hepatitis B virus vaccination and increase hepatitis B vaccine coverage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Family Characteristics
  • Female
  • Hepatitis B / economics*
  • Hepatitis B / prevention & control
  • Hepatitis B / psychology
  • Hepatitis B / virology
  • Hepatitis B Vaccines / economics*
  • Hepatitis B virus / drug effects*
  • Humans
  • Malaysia
  • Male
  • Middle Aged
  • Surveys and Questionnaires*
  • Vaccination / economics*
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data

Substances

  • Hepatitis B Vaccines

Grants and funding

This study was funded by the Putra Grant - Putra Graduate Initiative (IPS), grant number GP-IPS/2013-939220 to YR. HH is supported by Department of Foreign Affairs and Trade, Scholarship for International Affairs and Trade, Scholarship for International Research Fees (SIRF) from The University of Western Australia and NHMRC Centre of Research Excellence in Emerging Infectious Diseases (CREID). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.