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社会对癌症药物的价值取向是什么?在比利时人群中的离散选择实验。

What Does Society Value About Cancer Medicines? A Discrete Choice Experiment in the Belgian Population.

机构信息

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, P.O. Box 521, Onderwijs en Navorsing 2, Herestraat 49, 3000, Leuven, Belgium.

Department of Public Health and Primary Care, KU Leuven, 3000, Leuven, Belgium.

出版信息

Appl Health Econ Health Policy. 2019 Dec;17(6):895-902. doi: 10.1007/s40258-019-00504-4.

Abstract

BACKGROUND

Debate on pricing and reimbursement of cancer medicines highlights the need to establish the value of cancer medicines.

OBJECTIVE

This study aims to elicit the trade-offs in cancer medicine characteristics that the Belgian population is willing to make.

METHODS

A discrete choice experiment used six attributes with three levels each, based on literature and focus group discussions. The survey was sent to a random sample of 3500 Belgian citizens. Based on the choice of 961 respondents, individual parameters were estimated with a mixed logit model.

RESULTS

Societal value of cancer medicines was positively affected by a higher number of patients eligible for treatment, a high initial life expectancy and quality of life of patients, a high gain in quality of life and life expectancy due to treatment, and a low treatment cost. The value of 1-year gain in life expectancy was independent from the initial life expectancy of the patient. However, the value of one-point gain in quality of life was higher for patients with a low initial quality of life than for patients with a high initial quality of life.

CONCLUSIONS

This study has shown that gain in quality of life with cancer medicines is valued higher by Belgian society for patients who have lower initial quality of life before the start of treatment.

摘要

背景

癌症药物定价和报销的争论凸显了确定癌症药物价值的必要性。

目的

本研究旨在确定比利时人群愿意在癌症药物特征上做出哪些权衡。

方法

基于文献和焦点小组讨论,使用六个具有三个水平的属性进行离散选择实验。该调查被发送给 3500 名随机抽取的比利时公民。根据 961 名受访者的选择,使用混合 logit 模型估计个体参数。

结果

癌症药物的社会价值受到以下因素的积极影响:更多符合治疗条件的患者、患者初始预期寿命和生活质量高、治疗带来的生活质量和预期寿命的高增益、以及治疗成本低。一年预期寿命的增加的价值与患者的初始预期寿命无关。然而,对于初始生活质量较低的患者来说,每提高一个质量评分点的价值要高于初始生活质量较高的患者。

结论

本研究表明,对于开始治疗前生活质量较低的患者,比利时社会更看重癌症药物带来的生活质量增益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1366/6885509/51a13f661120/40258_2019_504_Fig1_HTML.jpg

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