Community views on factors affecting medicines resource allocation: cross-sectional survey of 3080 adults in Australia
Lesley Chim A I , Glenn Salkeld B , Patrick J Kelly C , Wendy Lipworth D , Dyfrig A. Hughes E and Martin R. Stockler F G HA Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW 2006, Australia. Email: lesleychim@gmail.com
B Faculty of Social Sciences, University of Wollongong, NSW, 2522, Australia. Email: gsalkeld@uow.edu.au
C Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. Email: p.kelly@sydney.edu.au
D Sydney Medical School, Sydney Health Ethics, University of Sydney, Sydney, NSW, 2006, Australia. Email: wendy.lipworth@sydney.edu.au
E Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Wales, LL57 2PZ, UK. Email: d.a.hughes@bangor.ac.uk
F National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.
G Concord Cancer Centre – Concord Hospital, Concord, NSW 2139, Australia.
H Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia. Email: martin.stockler@sydney.edu.au
I Corresponding author. Email: lesleychim@gmail.com
Australian Health Review 43(3) 254-260 https://doi.org/10.1071/AH16209
Submitted: 2 August 2017 Accepted: 23 November 2017 Published: 19 April 2018
Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND
Abstract
Objective The aim of the present study was to determine Australian community views on factors that influence the distribution of health spending in relation to medicines.
Methods A cross-sectional web-based survey was performed of 3080 adults aged ≥18 years. Participants were asked to rank, in order of importance, 12 criteria according to which medicines funding decisions may be made.
Results Of all respondents, 1213 (39.4%) considered disease severity to be the most important prioritisation criterion for funding a new medicine. This was followed by medicines treating a disease affecting children (13.2%) and medicines for cancer patients (9.1%). Medicines targeting a disease for which there is no alternative treatment available received highest priority from 8.6% of respondents. The remaining eight prioritisation criteria were each assigned a top ranking from 6.6% to 1.7% of respondents. Medicines targeting a disease for which there is no alternative treatment available were ranked least important by 7.7% of respondents, compared with 2.4%, 1.9% and 1.0% for medicines treating severe diseases, diseases affecting children and cancer respectively. ‘End-of-life treatments’ and ‘rare disease therapies’ received the least number of highest priority rankings (2.0% and 1.7% respectively).
Conclusions These results provide useful information about public preferences for government spending on prescribed medicines. Understanding of public preferences on the funding of new medicines will help the Pharmaceutical Benefits Advisory Committee and government determine circumstances where greater emphasis on equity is required and help inform medicines funding policy that best meets the needs of the Australian population.
What is known about this topic? There is increased recognition of the importance of taking into account public preferences in the heath technology assessment (HTA) decision-making process.
What does this paper add? The Australian public view the severity of disease to be the most important funding prioritisation criterion for medicines, followed by medicines used to treat children or to treat cancer.
What are the implications for practitioners? The general public are capable of giving opinions on distributional preferences. This information can help inform medicines funding policy and ensure that it is consistent with the values of the Australian population.
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