Korenstein Deborah, Kaltenboeck Anna, Mamoor Maha, Chimonas Susan
Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY 10017 USA.
Med Sci Educ. 2021 Jan 13;31(2):489-494. doi: 10.1007/s40670-020-01190-x. eCollection 2021 Apr.
High US drug costs have garnered increasing attention, with multiple proposed reforms. While physicians are key stakeholders, medical education about drug pricing is not described, and medical students' understanding and attitudes are poorly understood. To assess students' awareness of drug pricing and its determinants, the authors conducted a cross-sectional, web-based survey of US medical students. Survey items included attitudes and knowledge around drug pricing and relevant education received (e.g., importance, quantity/quality of instruction). A composite knowledge score summed correct responses to 10 knowledge items. Descriptive statistics and tests were used to evaluate associations. Among 815 viewers of the survey invitation, 361 visited the survey and 240 completed it (view rate 44%; participation rate 77%; completion rate 87%). Most participants were white (62%), in MD programs (82%), and female (53%). Nearly all (> 99%) said it was somewhat or very important to understand factors influencing drug pricing; over 90% were interested in learning more. Among year 3-4 students ( = 108), 59% reported receiving medical school instruction on pricing; few rated the quantity as adequate (7%) or the quality as excellent (3%) or good (8%). Among 10 knowledge questions, the median correct score was 6. Fewer than half (44%) knew that prices are uncorrelated with research/development costs. Knowledge was associated with year in school ( = 0.011) but not reported instructional quality or quantity. In sum, medical students report interest in drug pricing but inadequate instruction, and their knowledge is incomplete. Enhanced education is needed to equip future doctors to advocate effectively for patients around drug prices.
The online version contains supplementary material available at 10.1007/s40670-020-01190-x.
美国高昂的药品成本已引起越来越多的关注，同时也有多项改革提议。虽然医生是关键利益相关者，但关于药品定价的医学教育却未被提及，而且医学生对此的理解和态度也鲜为人知。为了评估学生对药品定价及其决定因素的认知，作者对美国医学生进行了一项基于网络的横断面调查。调查项目包括对药品定价的态度和知识以及所接受的相关教育（例如，教育的重要性、数量/质量）。一个综合知识得分汇总了对10个知识项目的正确回答。使用描述性统计和检验来评估相关性。在815名收到调查邀请的人中，361人访问了调查，240人完成了调查（查看率44%；参与率77%；完成率87%）。大多数参与者是白人（62%），攻读医学博士项目（82%），女性（53%）。几乎所有人（>99%）表示理解影响药品定价的因素有点或非常重要；超过90%的人有兴趣了解更多。在三至四年级的学生（n = 108）中，59%的人报告在医学院接受过定价方面的教学；很少有人认为教学数量足够（7%）或教学质量优秀（3%）或良好（8%）。在10个知识问题中，正确得分的中位数是6。不到一半（44%）的人知道价格与研发成本无关。知识与在校年级相关（P = 0.011），但与报告的教学质量或数量无关。总之，医学生表示对药品定价感兴趣，但教学不足，且他们的知识不完整。需要加强教育，以使未来的医生能够有效地为患者在药品价格方面进行 advocacy。
在线版本包含可在10.1007/s40670-020-01190-x获取的补充材料。 （注：原文中“advocate effectively for patients around drug prices”中的“advocacy”翻译可能不太准确，这里暂且保留英文，因为准确意思需结合上下文进一步确定合适的中文表述）
