Eliciting societal preferences of reimbursement decision criteria for anti cancer drugs in South Korea

ABSTRACT

Introduction: In order to look beyond the cost-effectiveness analysis, this study used a multi-criteria decision analysis (MCDA), which reflects societal values with regard to reimbursement decisions. This study aims to elicit societal preferences of the reimbursement decision criteria for anti cancer drugs from public and healthcare professionals.

Methods: Eight criteria were defined based on a literature review and focus group sessions: disease severity, disease population size, pediatrics targets, unmet needs, innovation, clinical benefits, cost-effectiveness, and budget impacts. Using quota sampling and purposive sampling, 300 participants from the Korean public and 30 healthcare professionals were selected for the survey. Preferences were elicited using an analytic hierarchy process.

Results: Both groups rated clinical benefits the highest, followed by cost-effectiveness and disease severity, but differed with regard to disease population size and unmet needs. Innovation was the least preferred criteria.

Conclusions: Clinical benefits and other social values should be reflected appropriately with cost-effectiveness in healthcare coverage. MCDA can be used to assess decision priorities for complicated health policy decisions, including reimbursement decisions. It is a promising method for making logical and transparent drug reimbursement decisions that consider a broad range of factors, which are perceived as important by relevant stakeholders.

KEYWORDS:

• Analytic Hierarchy process (AHP)
• cancer
• Multi-Criteria Decision Analysis (MCDA)
• preference
• reimbursement

Acknowledgments

We would like to thank our participants in focus group sessions. Several attendees of the meetings contributed significantly to the discussions and to the ideas in this study, but who cannot be named owing to the sensitive nature of the topic in Korea. We wish to thank Hyun Jin Song, whose feedback was helpful in improving the manuscript. We are also thankful to Jin Hyun Nam for his consultations on the analyses.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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Additional information

Funding

This work was supported by the Korean Research-based Pharmaceutical Industry Association under Grant [S-2014-0595-000]. The organization had no interference of any kind in the research or in the manuscript writing.