The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia.
Swinburne University of Technology, School of Health Sciences, Department of Psychology, VIC 3122, Australia.
Health Policy. 2021 Mar;125(3):327-334. doi: 10.1016/j.healthpol.2020.12.002. Epub 2020 Dec 10.
In the past decade many novel, and in some cases transformative, cancer medicines have entered the market. Their prices and the amount spent on them by governments have increased rapidly, bringing to the forefront trade-offs that must be made. In this paper we explore the Australian public's attitude towards the funding of high cost cancer medicines (HCCM) to inform reimbursement and health technology assessment (HTA) policy.
A survey consisting of 49 questions about the funding of HCCMs was developed by the investigators. Recruitment was conducted via Qualtrics. 1039 Australian adults completed the survey.
The Australian public overwhelmingly supports funding of HCCMs (95.5 %) to enhance equity of access (97.8 %), and to respond to patients' needs (98 %). When respondents were challenged to balance equity versus access in different contexts inconsistencies emerged. Different demographic factors were important in predicting support for various strategies.
Our results suggest that the Australian public strongly supports government funding of HCCMs and values both equity and access. Equally, however, the public is uncertain about how equity and access are to be balanced and achieved, and such ambivalence needs to be both further explored and accommodated in policy processes. Our results may be used by policymakers in Australia, and countries with similar systems and values, to further develop policies and processes for funding HCCMs.
在过去的十年中，许多新型的、在某些情况下具有变革性的癌症药物已经进入市场。这些药物的价格以及政府为此类药物投入的资金迅速增加，这使得一些必须做出的权衡摆在了首位。本文旨在探讨澳大利亚公众对高价癌症药物（HCCM）资助的态度，以为报销和卫生技术评估（HTA）政策提供信息。
研究人员开发了一项包含 49 个问题的关于 HCCM 资助的调查。调查采用 Qualtrics 平台进行招募，共 1039 名澳大利亚成年人完成了调查。
绝大多数澳大利亚公众支持资助 HCCM，以增强获取途径的公平性（97.8%），并满足患者的需求（98%）。当受访者在不同情况下被要求平衡公平性与获取途径时，出现了不一致的情况。不同的人口统计学因素对支持各种策略的重要性不同。
我们的研究结果表明，澳大利亚公众强烈支持政府资助 HCCM，重视公平性和可及性。然而，公众对于如何平衡和实现公平性和可及性也存在不确定性，这种矛盾心理需要在政策过程中进一步探讨和考虑。我们的研究结果可以为澳大利亚和具有类似制度和价值观的国家的政策制定者提供信息，以进一步制定 HCCM 资助政策和流程。
