Iskedjian Michael, Desjardins Olivier, Piwko Charles, Bereza Basil, Jaszewski Barbara, Einarson Thomas R
PharmIdeas Research and Consulting Inc., Oakville, Ontario, Canada.
Pharmacoeconomics. 2009;27(2):149-58. doi: 10.2165/00019053-200927020-00005.
Multiple sclerosis (MS) is a chronic neurological disease that affects 240 per 100 000 Canadians. Of these patients, 10-80% (average 70%) experience pain. Sativex is a cannabis-based drug recently approved for neuropathic pain.
In this study, we determine individuals' preferences between two treatment options as well as the willingness to pay (WTP) for Sativex, expressed as the amount they would pay in insurance premiums to have access to that treatment.
The WTP instrument comprised a decision board as a visual aid, and a questionnaire. A decision board helps clinicians standardize the presentation of treatment information. In this study, the decision board described two treatment options: a three-drug combination (gabapentin, amytriptyline, acetaminophen [paracetamol] {i.e. pills}) and the three-drug combination plus Sativex (i.e. 'pills and oral spray'). Information on efficacy and adverse effects was taken from trial data; wording was guided by a panel of neurologists and tested for clarity on lay people. The instrument was administered to 500 participants from Canada's general population using the bidding game approach. Descriptive statistics were calculated.
Mean (SD) age of participants was 39 (13) years, with a female : male distribution of 56 : 44. The decision board was presented in both English (85%) and French (15%). Of 500 interviewees, 253 (50.6%) chose the 'pills and oral spray'. Mean monthly WTP for the insurance premium for those who chose the 'pills and oral spray' was Can dollars 8 (SD +/- 15, median 4, range 0-200).
Assuming that 51% of the general population are willing to pay additional premiums as reported in this study, the premiums collected would cover the cost of Sativex for all Canadian MS patients experiencing pain, with a surplus.
多发性硬化症（MS）是一种慢性神经疾病，每10万名加拿大人中有240人受其影响。在这些患者中，10%至80%（平均70%）会经历疼痛。Sativex是一种基于大麻的药物，最近被批准用于治疗神经性疼痛。
在本研究中，我们确定了个体在两种治疗方案之间的偏好以及对Sativex的支付意愿（WTP），以他们愿意支付的保险费金额来表示，以便能够获得该治疗。
WTP工具包括一个作为视觉辅助的决策板和一份问卷。决策板有助于临床医生规范治疗信息的呈现。在本研究中，决策板描述了两种治疗方案：一种是三种药物的组合（加巴喷丁、阿米替林、对乙酰氨基酚[扑热息痛]，即药片），另一种是三种药物组合加Sativex（即“药片和口腔喷雾剂”）。疗效和不良反应信息取自试验数据；措辞由一组神经学家指导，并对普通民众进行了清晰度测试。该工具采用投标博弈法对来自加拿大普通人群的500名参与者进行了测试。计算了描述性统计数据。
参与者的平均（标准差）年龄为39（13）岁，女性与男性的分布比例为56:44。决策板以英语（85%）和法语（15%）两种语言呈现。在500名受访者中，253人（50.6%）选择了“药片和口腔喷雾剂”。选择“药片和口腔喷雾剂”的人每月愿意支付的保险费平均为8加元（标准差±15，中位数4，范围0至200）。
假设如本研究报告所述，51%的普通人群愿意支付额外保费，那么所收取的保费将足以支付所有患有疼痛的加拿大MS患者使用Sativex的费用，并且还有盈余。
