■尽管新药的报销决定涉及价值判断,外行人的价值判断尚未得到彻底调查。这项研究量化了韩国当前药物报销系统中标准和子标准的公共价值(PV),并研究了与PV相关的社会人口统计学因素。
■使用层次分析法(AHP)来量化标准和子标准的PV。我们开发了一份问卷,以生成标准和子标准之间的成对比较矩阵。从2023年3月27日至4月1日,我们使用按年龄分层的配额抽样方法招募了1,000名研究参与者,性别,和基于韩国人口普查数据的地区。我们使用特征值方法来计算标准和子标准的PV。使用线性回归方法分析社会人口统计学因素对肺静脉的影响。
■标准的PV在临床有用性方面最高(28.5%),其次是成本效益(27.1%),预算影响(24.3%),以及其他国家的报销(20.1%)。参与者的社会人口统计学特征对标准的PV有重大影响。在其他国家,支付国家健康保险额外保费的意愿与PV的临床实用性和成本效益呈负相关,与PV的报销呈正相关。
■公众将临床实用性和成本效益作为主要标准。然而,标准的PV是不同的,并且与社会人口统计学因素相关.不同的公共利益需要一个有证据的审议过程来做出报销决定。
UNASSIGNED: This study quantified the public value (PV) of the criteria and sub-criteria in the current drug reimbursement systems in South Korea and examined sociodemographic factors that associated with PV.
UNASSIGNED: The Analytic Hierarchy Process (AHP) was used to quantify the PVs of criteria and sub-criteria. We developed a questionnaire to generate pairwise comparison matrices among criteria and sub-criteria. From 27 March to 1 April 2023, we recruited 1,000 study participants using a quota sampling method stratified by age, sex, and region based on Korean census data.
UNASSIGNED: The PVs for the criteria were highest for clinical usefulness (28.5%), followed by cost-effectiveness (27.1%), budget impact (24.3%), and reimbursement in other countries (20.1%). The sociodemographic characteristics of the participants had a significant impact on the PVs of the criteria. Willingness to pay additional premiums for national health insurance was negatively associated with PV for clinical usefulness and cost-effectiveness and positively associated with PV for reimbursement in other countries.
UNASSIGNED: The public prioritized clinical usefulness and cost-effectiveness as the main criteria. However, the PVs of the criteria were divergent and associated with sociodemographic factors. Divergent public interests require an evidence-informed deliberative process for reimbursement decisions.