Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90110, Thailand.
Res Social Adm Pharm. 2013 Nov-Dec;9(6):731-40. doi: 10.1016/j.sapharm.2012.08.006. Epub 2012 Oct 23.
The drug benefit plan of Thailand's Civil Servant Medical Benefit Scheme (CSMBS) must be amended to control increasing costs; to that end, it is important to gather the views of beneficiaries before making changes to the benefit plan.
To examine the relative importance of attributes of drug benefit plans from the perspective of CSMBS beneficiaries.
Attributes and levels adopted from focus group discussions and a preliminary survey were used to develop a questionnaire concerning hypothetical drug benefit plans. A convenience sample of 650 CSMBS beneficiaries in Songkhla province was asked to rate the drug benefit plans. To determine the beneficiaries' decision models, judgment analysis was used. Policy-capturing analysis was used to examine the beneficiaries' preferences, and cluster analysis was conducted to explore the variability among judgment plans. Judgment policy insight was also examined.
The results of the study showed that the beneficiaries weighed on cost-sharing as their most important attribute. The results remained unchanged, although only data from the beneficiaries who used the compensatory model were analyzed. The results of the cluster analysis showed that the largest cluster of beneficiaries weighed mostly on the cost-sharing attribute. The judgment policy insight results not only supported the finding that most beneficiaries focused on the cost-sharing attribute but also revealed that they might have the least understanding of how the formulary attribute affected beneficiaries' decision making.
Cost-sharing was the most important attribute for the CSMBS beneficiaries. This study indicated that a possible preferred drug benefit plan should have no cost-sharing, permit access only to drugs listed in a closed formulary, allow beneficiaries to obtain 3 months of drugs, and allow them to obtain drugs from either a community pharmacy or a government hospital.
为控制不断上涨的成本，泰国公务员医疗福利计划（CSMBS）的药品福利计划必须进行修订；为此，在对福利计划进行修改之前，征求受益人的意见非常重要。
从 CSMBS 受益人的角度考察药品福利计划的属性的相对重要性。
采用焦点小组讨论和初步调查中采用的属性和水平来制定一份关于假设药品福利计划的问卷。在 Songkhla 省，采用便利抽样法调查了 650 名 CSMBS 受益人，要求他们对药品福利计划进行评分。为了确定受益人的决策模型，采用了判断分析。采用政策捕捉分析来考察受益人的偏好，并进行聚类分析以探索判断计划之间的可变性。还考察了判断政策洞察力。
研究结果表明，受益人的首要考虑因素是共付额。尽管仅分析了使用补偿模型的受益人的数据，但结果仍然不变。聚类分析的结果表明，最大的受益人群体主要看重共付额属性。判断政策洞察力的结果不仅支持了大多数受益人关注共付额属性的发现，还表明他们可能对药物目录属性如何影响受益人的决策过程了解最少。
共付额是 CSMBS 受益人的最重要属性。本研究表明，一个可能的首选药品福利计划应该没有共付额，仅允许使用封闭式药物目录中的药物，允许受益人获得 3 个月的药物，并允许他们从社区药房或政府医院获得药物。
