Chim Lesley, Salkeld Glenn, Kelly Patrick J, Lipworth Wendy, Hughes Dyfrig A, Stockler Martin R
Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW 2006, Australia. Email.
Faculty of Social Sciences, University of Wollongong, NSW, 2522, Australia. Email.
Aust Health Rev. 2019 Jul;43(3):254-260. doi: 10.1071/AH16209.
Objective The aim of the present study was to determine Australian community views on factors that influence the distribution of health spending in relation to medicines. Methods A cross-sectional web-based survey was performed of 3080 adults aged ≥18 years. Participants were asked to rank, in order of importance, 12 criteria according to which medicines funding decisions may be made. Results Of all respondents, 1213 (39.4%) considered disease severity to be the most important prioritisation criterion for funding a new medicine. This was followed by medicines treating a disease affecting children (13.2%) and medicines for cancer patients (9.1%). Medicines targeting a disease for which there is no alternative treatment available received highest priority from 8.6% of respondents. The remaining eight prioritisation criteria were each assigned a top ranking from 6.6% to 1.7% of respondents. Medicines targeting a disease for which there is no alternative treatment available were ranked least important by 7.7% of respondents, compared with 2.4%, 1.9% and 1.0% for medicines treating severe diseases, diseases affecting children and cancer respectively. 'End-of-life treatments' and 'rare disease therapies' received the least number of highest priority rankings (2.0% and 1.7% respectively). Conclusions These results provide useful information about public preferences for government spending on prescribed medicines. Understanding of public preferences on the funding of new medicines will help the Pharmaceutical Benefits Advisory Committee and government determine circumstances where greater emphasis on equity is required and help inform medicines funding policy that best meets the needs of the Australian population. What is known about this topic? There is increased recognition of the importance of taking into account public preferences in the heath technology assessment (HTA) decision-making process. What does this paper add? The Australian public view the severity of disease to be the most important funding prioritisation criterion for medicines, followed by medicines used to treat children or to treat cancer. What are the implications for practitioners? The general public are capable of giving opinions on distributional preferences. This information can help inform medicines funding policy and ensure that it is consistent with the values of the Australian population.
目的 本研究旨在确定澳大利亚社区对影响药品相关卫生支出分配因素的看法。方法 对3080名年龄≥18岁的成年人进行了基于网络的横断面调查。参与者被要求按照重要性顺序对12项药品资助决策标准进行排序。结果 在所有受访者中，1213人（39.4%）认为疾病严重程度是资助新药的最重要优先排序标准。其次是治疗影响儿童疾病的药物（13.2%）和癌症患者用药（9.1%）。针对无替代治疗方法疾病的药物，8.6%的受访者将其列为最高优先。其余八项优先排序标准，每项被列为最高优先的受访者比例从6.6%到1.7%不等。针对无替代治疗方法疾病的药物，7.7%的受访者将其列为最不重要，而治疗严重疾病、影响儿童疾病和癌症的药物，这一比例分别为2.4%、1.9%和1.0%。“临终治疗”和“罕见病治疗”获得最高优先排序的数量最少（分别为2.0%和1.7%）。结论 这些结果为政府在处方药支出方面的公众偏好提供了有用信息。了解公众对新药资助的偏好将有助于药品福利咨询委员会和政府确定需要更加强调公平性的情况，并有助于制定最能满足澳大利亚民众需求的药品资助政策。关于该主题已知的情况是什么？在卫生技术评估（HTA）决策过程中考虑公众偏好的重要性得到了越来越多的认可。本文补充了什么？澳大利亚公众认为疾病严重程度是药品资助最重要的优先排序标准，其次是用于治疗儿童或癌症的药物。对从业者有何启示？普通公众能够就分配偏好发表意见。这些信息有助于为药品资助政策提供参考，并确保其与澳大利亚民众的价值观一致。
