Willingness to pay for a second pair of near-vision glasses: a cross-sectional study in a rural North Indian population

Purpose: There is an enormous unmet need for near vision correction with glasses. The cost and lack of felt need are important barriers. This study, which was conducted among a rural population of northern India, was designed to assess whether the short-term use of a pair of near-vision glasses can increase the desirability for individuals to procure subsequent pairs and to further assess the willingness to pay thresholds. Methods: This study followed a quasi-experimental design. Uncorrected presbyopes were given near vision glasses at their doorstep, to carry out their chosen near work task for half- an- hour (this use of glasses was referred to as ‘experience’ for the purpose of this study). They were then referred to nearby vision centres to procure glasses. This ‘experience’ given was used as a proxy for having used the first pair. At the vision centre, glasses were offered at no cost, for Indian Rupees 75 (US$0.90) and for Indian Rupees 100 (US$1.20) in the first, second and third phases of the study, respectively. The usual price at which near-vision glasses were otherwise available in the region was Indian Rupees150 (US$1.8). The uptake of glasses after having received the near correction experience was tracked via the Peek Vision platform. Results: The most preferred chosen near work task by the study participants were stitching, after threading the needle and using a mobile phone. The uptake of near-vision glasses from the vision centre after providing the desired experience was 81.4% (835/1,026), 48.3% (699/1,446) and 29.2% (93/318) when the glasses were provided free of cost, at $0.90 and at $1.20 respectively. The difference between these three phases was statistically significant (p < 0.001). Uptake was found to be increase with need for increasing lens power (p < 0.01) and especially among those who reported the ‘experience’ as ‘very good’ or ‘excellent’(p < 0.001). Uptake decreased with increasing age (p < 0.01). Differences in uptake between sexes and between those with or without the availability of a mode of transport in their household were not found to be significant. Conclusion: Having experience with the first pair of near-vision glasses can increase desirability of procuring subsequent pairs. Offering the second pair at a reduced price can increase the uptake substantially in this setting, suggesting that active outreach to correct near vision in tandem with accessible and affordable marketplaces for reading glasses could provide a viable solution to scale near vision correction.