McMichael Alan J, Kane Joseph P M, Rolison Jonathan J, O'Neill Francis A, Boeri Marco, Kee Frank
PhD, Health & Social Care Public Health Agency, Belfast, UK.
PhD, Centre for Public Health, Queen's University Belfast, Belfast, UK.
BJPsych Open. 2022 Feb 3;8(2):e40. doi: 10.1192/bjo.2022.9.
Public support for the implementation of personalised medicine policies (PMPs) within routine care is important owing to the high financial costs involved and the potential for redirection of resources from other services.
We aimed to determine the attributes of a PMP most likely to elicit public support for implementation. We also aimed to determine whether such support differed between a depression PMP and one for cystic fibrosis.
In a discrete-choice experiment, paired vignettes illustrating both the current model of care (CMoC) and a hypothetical PMP for either depression or cystic fibrosis were presented to a representative sample of the UK public (n = 2804). Each vignette integrated varying attributes, including anticipated therapeutic benefit over CMoC, and the annual cost to the taxpayer. Respondents were invited to express their preference for either the PMP or CMoC within each pair.
The financial cost was the most important attribute influencing public support for PMPs. Respondents favoured PMP implementation where it benefited a higher proportion of patients or was anticipated to be more effective than CMoC. A reduction in services for non-eligible patients reduced the likelihood of support for PMPs. Respondents were more willing to fund PMPs for cystic fibrosis than for depression.
Cost is a significant factor in the public's support for PMPs, but essential caveats, such as protection for services available to PMP-ineligible patients, may also apply. Further research should explore the factors contributing to condition-specific nuances in public support for PMPs.
由于实施个性化医疗政策（PMPs）涉及高昂的财务成本以及存在从其他服务重新分配资源的可能性，因此公众对在常规护理中实施该政策的支持至关重要。
我们旨在确定最有可能引发公众对实施PMPs支持的属性。我们还旨在确定抑郁症PMP和囊性纤维化PMP之间的这种支持是否存在差异。
在一项离散选择实验中，向英国公众的代表性样本（n = 2804）展示了成对的短文，这些短文说明了当前的护理模式（CMoC）以及针对抑郁症或囊性纤维化的假设性PMP。每个短文综合了不同的属性，包括相对于CMoC预期的治疗益处以及纳税人的年度成本。邀请受访者在每对短文中表达他们对PMP或CMoC的偏好。
财务成本是影响公众对PMPs支持的最重要属性。受访者赞成实施PMPs，前提是它能使更高比例的患者受益，或者预期比CMoC更有效。减少对不符合条件患者的服务会降低对PMPs支持的可能性。受访者更愿意为囊性纤维化的PMPs提供资金，而不是为抑郁症的PMPs提供资金。
成本是公众对PMPs支持的一个重要因素，但也可能适用一些基本的注意事项，例如保护不符合PMP条件的患者可获得的服务。进一步的研究应探索导致公众对PMPs支持存在特定疾病细微差别的因素。
