RESUMEN
Policy debate about funding criteria for drugs used to treat rare, orphan diseases is gaining prominence. This study presents evidence from a discrete choice experiment using a convenience sample of university students to investigate individual preferences regarding public funding for drugs used to treat rare diseases and common diseases. This pilot study finds that: other things equal, the respondents do not prefer to have the government spend more for drugs used to treat rare diseases; that respondents are not willing to pay more per life year gained for a rare disease than a common disease; and that respondents weigh relevant attributes of the coverage decisions (e.g. costs, disease severity and treatment effectiveness) similarly for both rare and common diseases. The results confirm the importance of severity and treatment effectiveness in preferences for public funding. Although this is the first study of its kind, the results send a cautionary message regarding the special treatment of orphan drugs in coverage decision-making.
Asunto(s)
Conducta de Elección , Gastos en Salud/estadística & datos numéricos , Política de Salud/economía , Producción de Medicamentos sin Interés Comercial/economía , Medicamentos bajo Prescripción/economía , Enfermedades Raras/economía , Investigación Biomédica , Análisis Costo-Beneficio , Toma de Decisiones , Femenino , Costos de la Atención en Salud , Humanos , Masculino , Modelos Econométricos , Análisis Multivariante , Proyectos Piloto , Enfermedades Raras/tratamiento farmacológico , Estudiantes , Estados Unidos , Universidades , Adulto JovenRESUMEN
A consistent finding from many reviews is that undergraduate Grade Point Average (uGPA) is a key predictor of academic success in medical school. Curiously, while uGPA has established predictive validity, little is known about its reliability. For a variety of reasons, medical schools use different weighting schemas to combine years of study. Additional concerns relate to the equivalence of grades obtained from different fields of study and institutions, with little hard data to guide conclusions. At the Michael G. DeGroote School of Medicine Class of 2007 at McMaster University, every undergraduate grade of 2,138 applicants, along with field of study and post-secondary educational institution, was analyzed. Individual grades were aggregated into an overall uGPA using published algorithms from several medical school, and correlated with a non-weighted sum. Correlations of the different schemas with equal weights ranged from 0.973 to 0.990. The extent of the difference between fields of study was small, accounting for only 1.5% of the variance. However, differences among 16 Ontario universities were larger, and accounted for 9.3% of the variance. The results of this study suggest that all weighting schemas are virtually equivalent, making any formulation reasonable. Differences by field of study are small, but do not show any bias against non-science students. Differences by institution are larger, amounting to a range in average score from 78.7 to 84.6; however it is not clear whether this reflects candidate ability or institutional policy, so attempts to correct for institution may be difficult.