A survey of Australian public attitudes towards funding of high cost cancer medicines

Narcyz Ghinea; Christine Critchley; Bronwen Morrell; Ian Kerridge; Terry Campbell; Richard Day; Madlen Gazarian; David Isaacs; Winston Liauw; Ian Olver; Jessica Pace; Sallie Pearson; Glenn Salkeld; Wendy Lipworth

doi:10.1016/j.healthpol.2020.12.002

A survey of Australian public attitudes towards funding of high cost cancer medicines

Health Policy. 2021 Mar;125(3):327-334. doi: 10.1016/j.healthpol.2020.12.002. Epub 2020 Dec 10.

Authors

Affiliations

¹ The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia. Electronic address: [email protected].
² Swinburne University of Technology, School of Health Sciences, Department of Psychology, VIC 3122, Australia.
³ The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia.
⁴ The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia; Haematology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
⁵ UNSW Sydney, Faculty of Medicine, NSW 2052, Australia; St Vincent's Hospital Sydney, NSW 2010, Australia.
⁶ UNSW Sydney, St Vincent's Clinical School, NSW 2010, Australia.
⁷ UNSW Sydney, Faculty of Medicine, NSW 2052, Australia.
⁸ The University of Sydney, Faculty of Medicine and Health, NSW 2050, Australia; The Children's Hospital at Westmead, NSW 2145, Australia.
⁹ UNSW Sydney, St George and Sutherland Clinical School, NSW 2217, Australia.
¹⁰ The University of Adelaide, Faculty of Health and Medical Sciences, School of Psychology, Australia.
¹¹ UNSW Sydney, Centre for Big Data Research in Health, NSW 2052, Australia; The University of Sydney, Faculty of Medicine and Health, Menzies Centre for Health Policy, NSW 2006, Australia.
¹² The University of Wollongong, Faculty of Social Sciences, NSW 2522, Australia.

PMID: 33402264
DOI: 10.1016/j.healthpol.2020.12.002

Abstract

Background: In the past decade many novel, and in some cases transformative, cancer medicines have entered the market. Their prices and the amount spent on them by governments have increased rapidly, bringing to the forefront trade-offs that must be made. In this paper we explore the Australian public's attitude towards the funding of high cost cancer medicines (HCCM) to inform reimbursement and health technology assessment (HTA) policy.

Methods: A survey consisting of 49 questions about the funding of HCCMs was developed by the investigators. Recruitment was conducted via Qualtrics. 1039 Australian adults completed the survey.

Results: The Australian public overwhelmingly supports funding of HCCMs (95.5 %) to enhance equity of access (97.8 %), and to respond to patients' needs (98 %). When respondents were challenged to balance equity versus access in different contexts inconsistencies emerged. Different demographic factors were important in predicting support for various strategies.

Conclusion: Our results suggest that the Australian public strongly supports government funding of HCCMs and values both equity and access. Equally, however, the public is uncertain about how equity and access are to be balanced and achieved, and such ambivalence needs to be both further explored and accommodated in policy processes. Our results may be used by policymakers in Australia, and countries with similar systems and values, to further develop policies and processes for funding HCCMs.

Keywords: Access to health care; Cancer; Health care technology; Health equity; Health insurance; High-cost medicines.

MeSH terms

Adult
Attitude
Australia
Drug Costs*
Humans
Neoplasms* / drug therapy
Surveys and Questionnaires