Sharing and the Provision of “Cost-Ineffective” Life-Extending Services to Less Severely Ill Patients

Abstract

Results suggest that sharing per se is important and that the public would support some funding of cost-ineffective services for less severe health problems.

What Aspects of Illness Influence Public Preferences for Healthcare Priority Setting? A Discrete Choice Experiment in the UK

“…We do however find that the public place high value on providing treatment for conditions with unmet medical need. This is arguably consistent with studies identifying a preference for inclusive sharing that avoids leaving some groups of patients without treatment [ 18 , 20 , 46 , 47 ]. Unmet need is currently handled in UK HTA through the deliberative process.…”

Communal Sharing and the Provision of Low-Volume High-Cost Health Services: Results of a Survey

“…VAS scores for the two sets of health states and the estimated TTO utilities are reported in Table 3 . For the top two states—slight and moderate problems—the average VAS scores were 4 and 3 percentage points lower than those obtained in the earlier survey [ 31 ], which were incorporated in the figures. The lower health state utilities were identical to the earlier estimates.…”

“…The descriptions of health states in these figures were aligned with the percentage of cost coverage, the numerical value of which equalled 100 times the utility of the health states. These were obtained from an earlier study that had used the same scale and descriptors [ 31 ]. Therefore, in selecting a level of cost coverage, respondents were selecting the health state utility that would be experienced by patients if they contracted the illness.…”

Valuation of Treatments for Rare Diseases: A Systematic Literature Review of Societal Preference Studies

“…When risk reduction/elimination was smaller (5 per 100,000), differences were reduced and only of borderline significance for ALS ( P = .047) and fatal road traffic accidents ( P = .054). Eliminating risk was associated with a premium of approximately 20% Richardson et al (2019) [ 43 ] Review (−) NR NR NR (1) “Survey evidence indicates no preference for the special treatment of RDs when the choice is between rare and common diseases… Rarity per se is not viewed as a reason for special treatment” Richardson et al (2018) [ 44 ] Australia Society Citizen CSPC NR (+) NR NR (2) The urgency of the patient’s illness had a significant effect, resulting in almost twice the allocation of LY to the patient with an LE of 2 years compared with patients with an LE of 10 years (5.8 vs. 3.2 years). Although survey respondents reacted as expected to differences in the cost effectiveness of services and to differences in the severity of the patient’s condition, they continued to allocate some part of the notional budget to the patient who would receive no support in a health-maximizing or severity-focused health service.…”

“…According to a published literature review, members of the general public often gave priority to patients with more severe disease, regardless of size of the health gain or the cost of treatment [ 40 ]. Some studies reported that survey respondents were willing to prioritize more severe diseases over potential health gains [ 36 , 43 , 44 ]. A trade-off study from Australia supported the view that members of the general public prefer health programs that do not leave patients in severe health states.…”