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Engaging the Canadian public on reimbursement decision-making for drugs for rare diseases: a national online survey

机译:在稀有疾病的毒品中,将加拿大公众参与偿还决策:国家在线调查

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摘要

Abstract Background Funding of drugs for rare diseases (DRDs) requires decisions that balance fairness for all individuals within the healthcare system with compassion for affected individuals. Our study objective was to conduct a national online survey to determine the Canadian public’s perspective, including regional variations, associated with DRD decision-making. Methods The survey collected responses from 1631 Canadians. Respondents were asked to rank at least three and up to five DRD decision-making priorities, out of a total of eight priorities presented. They were also asked to compare and rate their agreement level on a 5-point Likert scale with four funding scenarios described. The frequency of each priority, independent of where it was ranked in relation to the other priorities, was calculated. Regression analyses were conducted to measure the association between respondents’ demographics and selected priorities with their agreement level for each funding scenario. Results Among the survey respondents, Improved Quality of Life and Effective Health Care were most frequently selected as top priorities. Also, 79.2% of respondents agreed with equal access to DRDs across Canada, and 73.0% agreed with DRD funding if additional expenses are justified in the DRD’s cost-effectiveness. Approximately half agreed to pay for DRDs independent of their effectiveness. There were no geographic differences in priorities. Selecting Effective Health Care in the top priorities was positively associated with both prioritizing other programs over programs for rare diseases and DRD funding only if deemed as cost-effective. Respondents, who selected National Access as one of the top priorities, were less likely to agree to fund DRDs only if deemed as cost-effective and were more likely to agree with the scenario to provide national access to DRDs. Conclusions The survey results suggest the level of public support for funding decisions and programs that incorporate assessment of the effectiveness of drugs for improving quality of life, and to promote similar access across Canada. The responses anticipate public responses to different policy scenarios and the priorities that underlie them. Decision-makers may find it useful to consider whether and how to incorporate these results into policy decisions and their justification to citizens and patients.
机译:摘要为罕见疾病(DRDS)的药物的背景资金需要决定,使医疗保健系统内所有个人的公平与受影响的人同情。我们的研究目标是在国家在线调查进行,以确定加拿大公众的角度,包括与DRD决策相关的区域变异。方法调查收集了1631名加拿大人的回应。要求受访者举行至少三个和最多五个DRD决策优先事项,其中包括八个优先事项。他们还被要求将他们的协议水平进行比较,并在具有四个资金方案中描述的5点李克特量表。计算每个优先级的频率,与其与其他优先级相比排名的位置无关。进行回归分析,以衡量受访者人口统计数据与所选优先事项的关联,他们的协议水平适用于每种筹资方案。结果调查受访者之间的结果,提高生活质量和有效的医疗保健最常被选为顶级优先事项。此外,79.2%的受访者同意加拿大跨国公司的平等机会,如果额外的费用以DRD的成本效益合理,则与DRD资金同意的73.0%。大约一半同意为无关支付无关的DRDS。优先事项没有地理差异。选择有效的医疗保健在最优先事项中,只有在被视为成本效益的情况下,只有在优先考虑罕见疾病和DRD资金的方案的优先级。被选中作为最高优先级之一的受访者,仅当被视为成本效益并更有可能同意该方案的才能同意基于DRDS的资金,以便提供国家机会的渠道。结论调查结果表明,融资和方案的公众支持水平,纳入评估毒品效力,以提高生活质量,并促进加拿大的类似机会。该答案预计对不同政策情景的公共响应以及借助他们的优先事项。决策者可能会发现考虑是否以及如何将这些结果纳入政策决策及其对公民和患者的理由有用。

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