Educational attainment and disease severity are associated with willingness to pay for rosacea treatment in Southwest China: a cross-sectional study

Background Rosacea often requires long-term treatment and may impose substantial psychosocial and financial burden. However, evidence on willingness to pay (WTP) for Rosacea treatment and its socioeconomic and clinical correlates remains limited. Objective To examine factors associated with WTP among rosacea patients in Southwest China, using a proportional affordability metric to distinguish socioeconomic capacity from disease-specific factors. Methods In this cross-sectional study (2024–2025), 506 patients from a tertiary hospital completed surveys assessing WTP and Rosacea Quality of Life (RosaQoL), while clinical severity was rated by dermatologists. Univariate analysis (chi-square test) and binary logistic regression models were employed to examine factors associated with WTP among patients in Southwest China. Results Among 506 rosacea patients (91.1% female, mean age 35.3 years), mean WTP was 25.3% of monthly income. In multivariable analysis, educational attainment was associated with high WTP after adjustment for income, with significantly lower odds among patients with junior high school education or below and senior high school education compared with those with postgraduate education or above; the university/college group showed a borderline association. Pairwise contrasts also suggested lower odds of high WTP among patients with mild or moderate rosacea than among those with severe rosacea; however, the overall Wald test for disease severity was borderline ( p = 0.070), and the RosaQoL total score was not significant after adjustment. Conclusion In Southwest China, educational attainment was the factor most consistently associated with WTP for rosacea treatment, whereas clinician-rated disease severity showed a severity-related pattern that should be interpreted cautiously given the borderline overall Wald test. As educational attainment may partly reflect health literacy and socioeconomic positioning, counseling should incorporate education-sensitive communication to support informed, affordability-aware treatment decisions.