Publicação
Public stated preferences for pharmaceutical funding decisions
| Resumo: | Introduction: In Portugal, the pharmaceutical consumption is subsidized by public funds. The rising NHS expenditures and the recent need of cost containment policies emphasize the discussion on priority setting in health care and raise questions of which criteria are appropriate to support funding decisions. Decision-makers base the pharmaceutical funding grant on clinical and economical evidence. Vulnerable sub groups, such as chronically ill and elderly with low income, benefit of higher financing rates than the general population. Little is known about the preferences of the public for pharmaceutical funding criteria in Portugal. Discrete Choice Experiments (DCEs) are suitable for the estimation of stated preferences as they measure of benefit that describes the good through a bundle of attributes and levels and it is based on the assumption that an individual’s valuation depends upon the levels of these attributes. DCE have the potential to contribute to outcome measurement for use in economic evaluation, uniquely allowing the investigation of diverse questions, such as clinical, economic and ethical. Aim: This work seeks to investigate criteria considered important by the Portuguese public for allocating resources for pharmaceuticals. In particular, we estimate the importance of the severity of the disease for which the treatment is indicated, the prevalence of the disease in Portugal, the efficacy of the pharmaceutical and the government costs per person treated. Method: A self-completion DCE survey, with 18 binary choice sets, was administered to two samples of the general population. Choice data are used to consider the relative importance of changes across attribute levels, and to model utility scores and relative probabilities. Results: A total of 90 individual completed the DCE. For the levels and units presented in the DCE, all attributes were statistically significant, in both samples. The attributes “severity of the disease for which the pharmaceutical is indicated” and “efficacy of the new pharmaceutical” had the higher utility values. The coefficient for the cost attribute was negative. Conclusions: This is the first DCE in Portugal that extends the discussion of prioritization in the health care sector, namely on the pharmaceutical funding decision, to the general population. This study sets foundation for future research and supports the acceptability of the public for DCEs. |
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| Autores principais: | Aguiar, Magda Francisca Calás Oliveira Carvalho |
| Assunto: | Pharmaceuticals funding Pharmaceuticals reimbursement Stated preferences Discrete choice experiment Financiamento Medicamentos Preferências socias Escolha discreta |
| Ano: | 2013 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade do Minho |
| Idioma: | inglês |
| Origem: | RepositóriUM - Universidade do Minho |
| Resumo: | Introduction: In Portugal, the pharmaceutical consumption is subsidized by public funds. The rising NHS expenditures and the recent need of cost containment policies emphasize the discussion on priority setting in health care and raise questions of which criteria are appropriate to support funding decisions. Decision-makers base the pharmaceutical funding grant on clinical and economical evidence. Vulnerable sub groups, such as chronically ill and elderly with low income, benefit of higher financing rates than the general population. Little is known about the preferences of the public for pharmaceutical funding criteria in Portugal. Discrete Choice Experiments (DCEs) are suitable for the estimation of stated preferences as they measure of benefit that describes the good through a bundle of attributes and levels and it is based on the assumption that an individual’s valuation depends upon the levels of these attributes. DCE have the potential to contribute to outcome measurement for use in economic evaluation, uniquely allowing the investigation of diverse questions, such as clinical, economic and ethical. Aim: This work seeks to investigate criteria considered important by the Portuguese public for allocating resources for pharmaceuticals. In particular, we estimate the importance of the severity of the disease for which the treatment is indicated, the prevalence of the disease in Portugal, the efficacy of the pharmaceutical and the government costs per person treated. Method: A self-completion DCE survey, with 18 binary choice sets, was administered to two samples of the general population. Choice data are used to consider the relative importance of changes across attribute levels, and to model utility scores and relative probabilities. Results: A total of 90 individual completed the DCE. For the levels and units presented in the DCE, all attributes were statistically significant, in both samples. The attributes “severity of the disease for which the pharmaceutical is indicated” and “efficacy of the new pharmaceutical” had the higher utility values. The coefficient for the cost attribute was negative. Conclusions: This is the first DCE in Portugal that extends the discussion of prioritization in the health care sector, namely on the pharmaceutical funding decision, to the general population. This study sets foundation for future research and supports the acceptability of the public for DCEs. |
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