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探究韩国抗癌药物报销决策标准的社会偏好。

Eliciting societal preferences of reimbursement decision criteria for anti cancer drugs in South Korea.

作者信息

Kwon Sun-Hong, Park Sun-Kyeong, Byun Ji-Hye, Lee Eui-Kyung

机构信息

a School of Pharmacy , Sungkyunkwan University , Suwon , South Korea.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2017 Aug;17(4):411-419. doi: 10.1080/14737167.2017.1277144. Epub 2017 Jan 3.

Abstract

INTRODUCTION

In order to look beyond the cost-effectiveness analysis, this study used a multi-criteria decision analysis (MCDA), which reflects societal values with regard to reimbursement decisions. This study aims to elicit societal preferences of the reimbursement decision criteria for anti cancer drugs from public and healthcare professionals.

METHODS

Eight criteria were defined based on a literature review and focus group sessions: disease severity, disease population size, pediatrics targets, unmet needs, innovation, clinical benefits, cost-effectiveness, and budget impacts. Using quota sampling and purposive sampling, 300 participants from the Korean public and 30 healthcare professionals were selected for the survey. Preferences were elicited using an analytic hierarchy process.

RESULTS

Both groups rated clinical benefits the highest, followed by cost-effectiveness and disease severity, but differed with regard to disease population size and unmet needs. Innovation was the least preferred criteria.

CONCLUSIONS

Clinical benefits and other social values should be reflected appropriately with cost-effectiveness in healthcare coverage. MCDA can be used to assess decision priorities for complicated health policy decisions, including reimbursement decisions. It is a promising method for making logical and transparent drug reimbursement decisions that consider a broad range of factors, which are perceived as important by relevant stakeholders.

摘要

引言

为了超越成本效益分析,本研究采用了多标准决策分析(MCDA),该方法反映了社会在报销决策方面的价值观。本研究旨在从公众和医疗保健专业人员中引出关于抗癌药物报销决策标准的社会偏好。

方法

基于文献综述和焦点小组会议定义了八个标准:疾病严重程度、疾病人群规模、儿科目标、未满足的需求、创新性、临床益处、成本效益和预算影响。采用配额抽样和目的抽样,选取了300名韩国公众参与者和30名医疗保健专业人员进行调查。使用层次分析法引出偏好。

结果

两组均将临床益处评为最高,其次是成本效益和疾病严重程度,但在疾病人群规模和未满足的需求方面存在差异。创新性是最不受青睐的标准。

结论

在医疗覆盖范围内,临床益处和其他社会价值观应与成本效益适当结合。MCDA可用于评估复杂卫生政策决策(包括报销决策)的决策优先级。它是一种有前途的方法,可用于做出考虑广泛因素的合理且透明的药物报销决策,这些因素被相关利益相关者视为重要因素。

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