Mantovani L G, Monzini M S, Mannucci P M, Scalone L, Villa M, Gringeri A
Centre of Pharmacoeconomics, Department of Pharmacological Sciences, University of Milan, Italy.
Haemophilia. 2005 Nov;11(6):589-97. doi: 10.1111/j.1365-2516.2005.01159.x.
The provision of health care to patients with haemophilia through replacement of the deficient coagulation factor is the result of a complex interaction between patients, physicians and policy makers, each carrying their individual sets of preferences. Preferences of patients, physicians and pharmacists towards perceived viral safety, risk of inhibitor development, infusion frequency during prophylaxis, pharmaceutical dosage form, distribution modes and price were evaluated by conjoint analysis, using a discrete choice experiment. Overall 178 patients', 69 physicians and 58 pharmacists completed the study. Patients, physicians and pharmacists displayed preferences: (i) similar in direction and strength for risk of inhibitors and frequency of prophylaxis, (ii) similar in direction, but not in strength for perceived viral safety and price, with patients showing lower strength compared with physicians and pharmacists, and (iii) dissimilar in direction and/or strength for: (i) dosage form, which tested important only for pharmacists and (ii) distribution mode, which tested important for patients and physicians only. Our study provides evidence of the differences between different stakeholders in the preferences towards haemophilia replacement therapy, indicating that different opinions should be taken into account when planning optimal care.
通过替代缺乏的凝血因子为血友病患者提供医疗服务,是患者、医生和政策制定者之间复杂相互作用的结果,他们各自都有一套偏好。采用离散选择实验,通过联合分析评估了患者、医生和药剂师对感知到的病毒安全性、抑制剂形成风险、预防期间的输注频率、药物剂型、配送方式和价格的偏好。共有178名患者、69名医生和58名药剂师完成了该研究。患者、医生和药剂师表现出偏好:(i)在抑制剂风险和预防频率方面,方向和强度相似;(ii)在感知到的病毒安全性和价格方面,方向相似,但强度不同,患者的强度低于医生和药剂师;(iii)在以下方面,方向和/或强度不同:(i)剂型,仅对药剂师来说是重要考量因素;(ii)配送方式,仅对患者和医生来说是重要考量因素。我们的研究证明了不同利益相关者在血友病替代疗法偏好上的差异,表明在规划最佳治疗方案时应考虑不同意见。