Table 2.
Public attitudes in four countries about actual coverage decisions (in per cent)
| Germany (n=250), % (95% CI) | Italy (n=250), % (95% CI) | UK (n=250), % (95% CI) | USA (n=509), % (95% CI) | |
| In one country, the national government decided against (paying for/providing) a new drug for treating an advanced form of cancer. On average, the drug costs ($35 000/£21 000/€25 000) per patient. The drug does not cure the disease, but studies suggest that using the drug can add, on average, about 6 months to a patient's life. Some patients would gain only a short period, while others could gain a lot more time. If this decision not to (pay for/provide) this drug were made in (your country), would you approve or disapprove of the decision? | ||||
| Approve | 36 (28 to 43) | 39 (32 to 47) | 24 (17 to 30) | 37 (32 to 43) |
| Disapprove | 60 (53 to 68) | 51 (44 to 59) | 76 (69 to 82) | 59 (54 to 65) |
| In one country, two drugs were available to treat a debilitating condition in the elderly. One of the drugs costs about 100 times as much as the other. The more expensive one has been tested and shown to be effective for people with this condition. The less expensive one has not been tested in research studies for treating this illness. However, many physicians who specialise in the condition use the lower cost drug because they believe it is safe and effective for their patients. This is often referred to as using an off-label drug. The government in that country decided to pay for/provide/pay only the less expensive drug even though it had not been tested for this illness. If this decision only to (pay for/provide) the less expensive drug that had not been tested for this illness were made in (your country), would you approve or disapprove of the decision? | ||||
| Approve | 24 (18 to 31) | 25 (18 to 31) | 20 (14 to 26) | 26 (21 to 31) |
| Disapprove | 70 (63 to 78) | 71 (64 to 80) | 80 (74 to 86) | 71 (66 to 76) |
| A new drug is available for a serious debilitating disease. It does not cure the disease, but it can provide relief for the symptoms of the disease. In one country, the national government decided to (pay for/provide) this drug only for a limited number of patients because of the drug's high cost of ($15 000/£9000/€11 000) a year. The drug is reserved for those patients who are most likely to see significant health benefits. Some people have objected to the decision because they argue that other patients might also benefit from the drug. If this decision to (pay for/provide) this drug only for a limited number of patients were made in (your country), would you approve or disapprove of the decision? | ||||
| Approve | 28 (21 to 35) | 26 (20 to 32) | 27 (20 to 34) | 28 (22 to 33) |
| Disapprove | 66 (58 to 73) | 71 (64 to 77) | 72 (65 to 79) | 69 (64 to 75) |
| In one country, the national government decided against (paying for/providing) the use of an imaging technology for diagnosing certain types of cancers. The technology is more expensive than alternative methods, costing over ($2000/£1200/€1400) per use. After conducting an evaluation, a government organisation concluded that there was not enough scientific evidence to recommend using the technology for these other types of cancer. Other countries, however, actively use this technology for multiple types of cancer because many doctors believe it provides the best most detailed view of these other types of tumours. The evaluation organisation argued that existing studies have not conclusively proven that the technology has advantages over alternative methods and therefore should not be (paid for/provided). If this decision not to (pay for/provide) this technology to help diagnose these other types of cancer were made in (your country), would you approve or disapprove of the decision? | ||||
| Approve | 26 (19 to 32) | 53 (46 to 60) | 18 (13 to 24) | 34 (28 to 39) |
| Disapprove | 67 (60 to 75) | 39 (32 to 47) | 78 (71 to 84) | 63 (57 to 68) |
Source: Harvard School of Public Health/Alliance for Aging Research Survey, 2011.
‘Don't know/refused’ responses not shown.