医患双方对药品临床综合评价中不同维度的偏好差异与支付意愿研究

Study on Preference Differences and Willingness to Pay Between Doctors and Patients in Different Dimensions of Comprehensive Clinical Evaluation of Drugs

目的:以治疗心绞痛药品为例研究药品临床综合评价中医患双方对不同属性的偏好及支付意愿,为药品临床综合评价的具体应用提供参考。方法:采用离散选择实验,对医患双方进行问卷调查并进行数据分析。结果:各属性对医生的选择均有显著影响(P<0.05),按权重排序为有效性(33.18%)、安全性(21.66%)、适宜性(14.22%)、创新性(10.24%)、可获得性(8.79%)、经济性(7.35%)、可负担性(4.55%);对患者群体的选择有显著影响的属性按权重排序为有效性(37.98%)、安全性(31.83%)、适宜性(16.23%)、创新性(8.49%)。医生对不同属性下各水平改善的支付意愿均高于患者。结论:医患双方对药品临床综合评价中各属性和水平的偏好基本一致,但医生支付意愿高于患者;水平设置会影响患者对某些属性的敏感性。

Objective: To study the clinical evaluation of preference and willingness to pay for different attributes between doctors and patients by taking drugs for angina pectoris as an example, so as to provide references for the specific application of clinical comprehensive evaluation. Methods: A questionnaire survey was conducted between doctors and patients by discrete choice experiment, and the data were analyzed. Results: Each attribute had a significant impact on the choice of doctors(P<0.05). The order of weight was effectiveness(33.18%), safety(21.66%), suitability(14.22%), innovation(10.24%), availability(8.79%), economy(7.35%), affordability(4.55%). The attributes that had significant influence on the choice of patients group were ranked by weight as follows: effectiveness(37.98%), safety(31.83%), suitability(16.23%) and innovation(8.49%). Doctors’ willingness to pay for each level of improvement under different attributes was higher than that of patients. Conclusion: Both doctors and patients have the same preference for each attribute and level in the clinical comprehensive evaluation of drugs, but doctors’ willingness to pay is higher than that of patients. Level setting can affect the sensitivity of patients to certain attributes.