McMaster Evidence-based Practice Center, McMaster University, DTC Building 3rd Floor, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
BMC Health Serv Res. 2009 Dec 29;9:246. doi: 10.1186/1472-6963-9-246.
Public drug insurance plans provide limited reimbursement for Alzheimer's disease (AD) medications in many jurisdictions, including Canada and the United Kingdom. This study was conducted to assess Canadians' level of support for an increase in annual personal income taxes to fund a public program of unrestricted access to AD medications.
A telephone survey was administered to a national sample of 500 adult Canadians. The survey contained four scenarios describing a hypothetical, new AD medication. Descriptions varied across scenarios: the medication was alternatively described as being capable of treating the symptoms of cognitive decline or of halting the progression of cognitive decline, with either no probability of adverse effects or a 30% probability of primarily gastrointestinal adverse effects. After each scenario, participants were asked whether they would support a tax increase to provide unrestricted access to the drug. Participants who responded affirmatively were asked whether they would pay an additional $75, $150, or $225 per annum in taxes. Multivariable logistic regression analysis was conducted to examine the determinants of support for a tax increase.
Eighty percent of participants supported a tax increase for at least one scenario. Support was highest (67%) for the most favourable scenario (halt progression - no adverse effects) and lowest (49%) for the least favourable scenario (symptom treatment - 30% chance of adverse effects). The odds of supporting a tax increase under at least one scenario were approximately 55% less for participants who attached higher ratings to their health state under the assumption that they had moderate AD and almost five times greater if participants thought family members or friends would somewhat or strongly approve of their decision to support a tax increase. A majority of participants would pay an additional $150 per annum in taxes, regardless of scenario. Less than 50% would pay $225.
Four out of five persons in a sample of adult Canadians reported they would support a tax increase to fund unrestricted access to a hypothetical, new AD medication. These results signal a willingness to pay for at least some relaxation of reimbursement restrictions on AD medications.
在包括加拿大和英国在内的许多司法管辖区，公共药物保险计划对阿尔茨海默病（AD）药物的报销金额有限。本研究旨在评估加拿大人对增加个人所得税以资助无限制获得 AD 药物的公共计划的支持程度。
对加拿大的 500 名成年受访者进行了一项电话调查。该调查包含了四个描述一种假设的新 AD 药物的情景。不同的情景描述了药物的不同作用：能治疗认知能力下降的症状，或阻止认知能力下降的进展，且分别对应无副作用的可能性或 30%主要胃肠道副作用的可能性。在每个情景之后，参与者被问及是否支持增加税收以提供无限制的药物获取。对肯定回答的参与者，调查询问他们是否愿意每年额外支付 75、150 或 225 美元的税款。使用多变量逻辑回归分析来研究支持税收增加的决定因素。
80%的参与者至少对一个情景表示支持增加税收。最有利的情景（阻止进展-无副作用）的支持率最高（67%），最不利的情景（症状治疗-30%发生副作用的可能性）的支持率最低（49%）。如果参与者认为自己患有中度 AD，他们对健康状况的评价较高，或者如果他们认为家庭成员或朋友会对他们支持税收增加的决定表示有些或强烈的赞成，那么他们在至少一个情景下支持税收增加的几率将降低约 55%。如果参与者认为家庭成员或朋友会对他们支持税收增加的决定表示有些或强烈的赞成，那么他们在至少一个情景下支持税收增加的几率将增加近五倍。如果参与者认为自己患有中度 AD，那么他们在至少一个情景下支持税收增加的几率将降低约 55%。如果参与者认为家庭成员或朋友会对他们支持税收增加的决定表示有些或强烈的赞成，那么他们在至少一个情景下支持税收增加的几率将增加近五倍。大多数参与者无论情景如何，都愿意每年额外支付 150 美元的税款。不到 50%的人愿意支付 225 美元。
在加拿大成年受访者的样本中，有四分之三的人表示他们支持增加税收以资助获得一种假设的新 AD 药物。这些结果表明，人们愿意为至少部分放宽 AD 药物报销限制支付费用。
