Points of View The public's expectations of knowing about the price, system, and value of pharmaceuticals, the means by which they think it is desirable, and the opportunity and timing -Report on the Results of the Survey on Public Awareness of Prices, Systems and Values of Pharmaceuticals, Part 3

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Akiko Yoshida, Senior Researcher, Pharmaceutical Industry Policy Institute

1. Introduction

The author conducted a web-based questionnaire survey, "Survey on Awareness of Prices, Systems, and Values of Pharmaceuticals" (hereinafter referred to as "the Survey"), in order to understand the actual status of awareness and interest in the prices, systems (medical care at the time of consultation, drug prices and medical insurance systems related to pharmaceuticals, etc.), and values of pharmaceuticals by various attributes.

The results of this survey are reported in Part 1, which describes the public's awareness and interest in the price and system of pharmaceuticals, and the characteristics of the segments with high awareness and interest, and in Part 2, which describes the value of pharmaceuticals that the public values, in Policy Research Institute News No. 671 ⁾ and No. 682 ⁾ (hereinafter referred to as "the previous paper").

In this paper, as the third report of the results of this survey, we describe the public's expectations regarding the price, system, and value of pharmaceuticals, as well as the means, opportunities, and timing that the public considers desirable. Continuing from the previous paper, this paper also focuses on, analyzes, and reports the characteristics of the groups that value "values other than medical values.

Survey and analysis methods

Survey Method

The web-based survey was conducted in the following manner. It should be presented in advance that there are limitations in the characteristics of the survey, such as the fact that the respondents are limited to those who have access to the Internet.

Analysis Method

Crosstabulations and multiple regression analysis using a linear probability model were used.

3. respondent demographics 4. survey results (by question)

The main information related to the respondents' attributes is appended at the end of this section.

Survey and analysis results

Expectations for Knowledge of Pharmaceutical Prices, Systems, and Values

First, in order to ascertain the degree of expectation of knowing about the price, system, and value of pharmaceuticals, and the nature of that expectation, we asked the respondents what changes they thought would occur in themselves if they had the opportunity to learn about them in depth, and obtained responses (multiple responses). The results are shown in order of the percentage of respondents (Figure 1). (Figure 1) The results are also shown for each group that values the two "non-medical values" defined in the previous paper. Group 1 consists of those who selected "values other than medical values" at least once (1,032 respondents, 48.7%, excluding those who selected "productivity," "reintegration/return to work," and "reduced burden of caregiving") when answering multiple questions, and Group 2 consists of those who selected "productivity," "reintegration/return to work," and "reduced burden of caregiving" when answering multiple questions. Those who selected all of these (236 respondents, 11.1%) were designated as Group 2. Multiple regression analysis using a linear probability model with the expectation to know item as the explained variable, taking 1 if the respondent responded by selecting it, 0 otherwise, and Group 1 and Group 2 as the explanatory variables was conducted, and the characteristics that were statistically significant are listed in Table 1.

The results showed that the highest percentage of respondents (53.2%) selected "Increased understanding and acceptance of medicines," followed by "Appropriate use," 49.1%; "Increased interest in medicines," 41.3%; "Increased sense of value and appreciation of medicines," 37.5%; "Easier consultation with doctors and pharmacists," 33.5%; "Increased familiarity with medicines," and "Increased awareness of medicines. ⁽³⁾ "Will want to see the ^statement3)" (21.2%), and "Image of the pharmaceutical company will change" (14.8%) followed. 12.2% of the respondents answered that "no change" would occur.

These results indicate that respondents expect various changes as a result of learning about the price, system, and value of pharmaceuticals. In terms of expectations, many respondents answered that their awareness and interest would increase, as indicated by the large number of responses in the categories of "increased understanding and understanding," "increased interest and concern," and "increased sense of value and appreciation. Also, the top responses were "more likely to use medicines appropriately," "easier to consult with doctors and pharmacists," and "more likely to want to read the statement," indicating the expectation of a change in behavior when confronted with medical care.

In the group that emphasized "non-medical value," the order of the highest percentage of responses for the expectation of knowing was similar to that of the overall group, in common with the two groups. In both cases, the percentages were higher than in the overall group, and the tendency was greater in group 2 than in group 1. The percentage of "no change" was lower in Group 1 and Group 2 than in the overall group.

The results of the multiple regression analysis showed that Group 1 had a higher probability of selecting each of the expected items. Group 2 also had a high probability of selecting each expected item. A comparison of the coefficients (per item) for the expected items was higher for group 2 than for group 1, suggesting that group 2 was influential.

These results indicate that the probability of expecting more was higher for the group that values "non-medical values" in common with the two groups, and that group 2 had a higher probability of expecting more for any of the items than group 1. Although the possibility that Group 2 is biased toward positive responses cannot be ruled out, it is possible that the group that values "value other than medical value," especially Group 2, can expect to increase their own awareness, interest, and concern by learning about the price, system, and value of drugs, as well as to change their behavior when faced with medical Next, we will discuss the price, system, and value of medicines.

Desirable means of knowing about prices, systems, and values

Next, in order to ascertain the means by which they consider it desirable to learn about the price, system, and value of pharmaceuticals, we asked them "What means do you think are desirable?" and obtained their responses (multiple responses). The results are shown in order of the percentage of respondents (Figure 2). (Figure 2) The results are also shown by group of respondents who value "values other than medical values" (Figure 2). Multiple regression analysis using a linear probability model with the means item considered desirable to know as the explained variable, taking 1 for a choice response, 0 otherwise, and Group 1 and Group 2 as explanatory variables was conducted, and the characteristics that were statistically significant are listed in Table 2.

The results showed that "TV" had the highest percentage at 64.1%, followed by "Hearing from a doctor, nurse, pharmacist, or other healthcare professional" at 44.2%, "Newspaper" at 39.0%, "Learning in some setting, such as school education" at 37.0%, and "Website/app" at 30.7%. The other 0.9% responded "don't know" as well as "local publicity" and "radio.

These results indicate that "TV" and "Newspaper" are the most popular means of obtaining information, not only about the price, system, and value of drugs, in Japan, where mass media permeate people's ^{lives4) and} is a highly trusted means of obtaining information. The top responses were "Asked by doctors, nurses, pharmacists, and other medical professionals" and "Learned at some point in school education," indicating that there is a high demand for passive means of obtaining information through people.

Next, we analyzed the characteristics of the means by which respondents considered it desirable to learn about the price, system, and value of pharmaceuticals by attribute (Table 3), which was classified beforehand. Multiple regression analysis using a linear probability model with each means as the explained variable, taking 1 if the respondent selected the answer, 0 otherwise, and the attribute category as the explanatory variable, shows the characteristics of the attributes that were statistically significant, as shown in Table 4. The means are listed from top to bottom in the order in which they showed the highest percentage of desirability.

As the main result, "television" was the preferred means to learn about the price, system, and value of medicines, with a higher probability of selection among the attributes of "unemployed," "no family members in need of care," and "high subjective health" respondents. The next most likely to prefer "hearing from a doctor, nurse, pharmacist, or other health care professional" were "female," "have a family member in need of care," "have a medical condition or visit a doctor," and "have a high medical cost burden. Newspaper" was preferred by the respondents with the following attributes: older age, unemployed, higher level of final education, medical examination/disease, higher medical cost burden, lower level of medical cost burden, and higher level of perceived health. The coefficient for "unemployed" was large even among the attribute categories, suggesting that it is an attribute category with a large impact. The coefficients were also large for "have a medical examination or disease" and "high level of subjective health," indicating that these attributes have a significant impact on the respondents. The respondents who answered that "learning in some way, such as through school education," was desirable were more likely to be female, have a higher level of final education, have a lower annual household income, have a lower sense of the burden of medical expenses, and have a higher level of subjective health. The most common choices for electronic media, such as websites/apps, community sites such as SNS and blogs, and video sites such as YouTube, were selected most frequently by the respondents who answered "employed.

In the group that emphasized "non-medical value," the order of the most desirable means was generally similar to that of the overall group, in common with the two groups. In group 2, both means increased significantly from the total. Among the means, "Learning in some situation such as school education" (62.7%, third) and "Websites/apps" (50.4%, fourth) ranked higher in Group 1 and Group 2, respectively, than in the overall group.

The results of the multiple regression analysis indicate that Group 1 had a higher probability of selecting each of the methods that they considered desirable for knowing. Group 2 also had a high probability of selecting each of the desirable means of knowing. A comparison of the coefficients (item by item) for each of the means considered desirable to know was higher for group 2 than for group 1, suggesting that group 2 was influential.

These results suggest that "learning in some setting, such as school education" and "websites/apps" were more desired by the groups that valued "non-medical value," suggesting that "websites/apps" may also be effective when providing information to Group 2.

Desirable occasions and times to know about prices, systems, and values

Next, in order to ascertain the occasions and timing of desirability for learning about the price, system, and value of pharmaceuticals, respondents were asked "What occasions and timing do you think are desirable?" and their responses (multiple responses, top one) were obtained. The results are shown in order of the percentage of responses (Figure 3). (Figure 3) The results are also shown for each group that values "values other than medical values" (top one). Multiple regression analysis using a linear probability model with the opportunity and timing items considered desirable to know as the explained variable, 1 taken when the respondents responded by choice and 0 when they did not, and the attribute category as the explanatory variable, was conducted, and the characteristics that were statistically significant are listed in Table 5.

As a result, "school education (compulsory education)" received the highest percentage of multiple responses at 48.4%, followed by "school education (high school)" at 42.8%, "adult education" at 38.6%, "study sessions at medical institutions and pharmacies" at 33.3%, and "transmission by pharmaceutical companies, etc." at 32.8%. On the other hand, in terms of the most desirable occasion and time (top one answer), "school education (compulsory education)" was selected by 28.1%, "school education (high school)" by 14.7%, and the ranking changed to "transmission by pharmaceutical companies" at 14.0%, followed by "study sessions at medical institutions and pharmacies" at 12.6% and "education for working adults" at 11.0%. 11.0%. Another 1.2% responded "don't know" as well as "politics" and "during medical examinations.

As in the previous section, we then analyzed the characteristics of the most desirable opportunities and times to learn about the price, system, and value of pharmaceuticals by pre-segmented attributes. Table 6 shows the characteristics of the attributes that were statistically significant by multiple regression analysis using a linear probability model with each opportunity or time period as the explained variable, taking 1 if the respondent chose to answer, 0 otherwise, and Group 1 and Group 2 as the explanatory variables. They are listed from top to bottom in order of the percentage of occasions and times when they were considered desirable.

The main results show that "schooling (compulsory education)" was the most desirable opportunity and timing to learn about the price, system, and value of medicines, with the attributes "younger age" and "no medical examination or disease" having the highest probability of selection. The next most desirable attributes were "compulsory education (high school)" for respondents who had completed their last schooling and "low medical cost burden". The most desirable response for "Communication by pharmaceutical companies, etc." was selected most frequently by females and respondents with "low level of perceived health". The most desirable "Study sessions at medical institutions and pharmacies" was selected by respondents with "high medical cost burden," and the most desirable "Education for the elderly" was selected by respondents with "no family members in need of care" and "medical checkups/diseases," while "Learning opportunities by insurer (such as the insurance association to which one belongs)" was selected by respondents with "medical checkups/diseases" and "no medical checkups/diseases. The probability of selecting this option was higher for those who answered "no medical care" and "no medical care/disease.

Among the groups that placed importance on "non-medical value," in terms of the most desirable opportunities and times (top one response), Group 1 was similar to the overall group both in the selection rate of desirable opportunities and times to know and in the trend of characteristics in the order of highest to lowest. In Group 2, 34.3% selected "school education (compulsory education)," followed by "dissemination by pharmaceutical companies, etc." at 17.4%, and "school education (high school)" at 12.3%, indicating a high percentage compared to the total.

Multiple regression analysis revealed that both Group 1 and Group 2 respondents had a high probability of selecting each opportunity or time period that they thought was desirable for them to know. Comparison of the coefficients (per item) for each opportunity and time of year item considered desirable to know was higher for Group 2 than for Group 1, suggesting that Group 2 was influential. In many of the most desirable opportunities and times (top one response), the probability of selecting Group 2 "Schooling (compulsory education)" was high, although many of the items did not differ significantly.

From these results, it can be said that "transmission from pharmaceutical companies, etc." was selected and answered more often than the whole for Group 2, which emphasizes "values other than medical values," and was desired. It is possible that Group 2 pays attention to "communications from pharmaceutical companies" on a daily basis and has trust and expectations in them.

Reasons for desirability of knowing about prices, institutions, and value

Next, in order to understand the reasons for the desirability of knowing about the price, system, and value of pharmaceuticals, we asked the respondents why they thought the answer to the previous question (the most desirable opportunity and time) was desirable, and obtained responses (multiple answers). The results are shown in Figures 4-1 and 4-2 in the order of the top four most desirable opportunities and times in terms of percentage of responses. A summary of the reasons for all nine opportunities and times presented will be included in the text.

Regarding "school education (compulsory education)," which received the highest percentage, 77.0% of respondents chose "compulsory education is free and everyone can receive it," followed by 48.7% who chose "it is easy to secure time to learn," 22.7% who chose "it is easy for anyone to participate," and 21.8% who chose "it is considered an appropriate age to learn about prices, systems, and values. followed at 21.8%. The next highest percentage was for "School education (high school)," at 59.2%, followed by "Because it is easy to secure time to learn," at 56.9%, "Because I think I am at an appropriate age to learn about prices, systems, and values," and "Because I am old enough to visit a medical institution by myself and receive medicine," at 27.7%. As for "transmission by pharmaceutical companies, etc.," 51.0% of the respondents selected "because they are the most knowledgeable about drugs," followed by 44.9% who selected "because people who want to know can obtain correct information at any time. Regarding "Study sessions at medical institutions and pharmacies," 42.9% of the respondents selected "Because I want my family doctor or pharmacy to teach me about it," followed by 37.2% who selected "Because it will increase my chances of receiving medical care and medicine," 33.1% who selected "Because I know the most about medicine," and 32.9% who selected "Because anyone who wants to know about it can always get the right information. The next most common reason was "Education for working people" at 37.2%. As for "adult education," 54.5% of respondents selected "because it is time to start paying medical expenses (premiums and co-pays) by myself" the most, followed by 49.8% for "because I think I am at an appropriate age to learn about prices, systems and values," 30.5% for "because I will have more opportunities to receive medical care and receive medicine," and 32.3% for "because people who want to know about it can always get the right information. The other reason was that "people who want to know can obtain correct information anytime" at 26.2%, followed by "because they are old enough to visit medical institutions alone or receive medicine" at 24.9%. As for "education for the elderly," 62.9% selected "because they will have more opportunities to receive medical care and medicine," 63.0% selected "because it is easy for anyone to participate" for "public lectures (for all generations)," and 47.6% selected "because they are the right age to learn about prices, systems and values" for "school education (vocational school, university and above). As for "Learning opportunities by insurer (e.g., health insurance association to which one belongs)," the highest response rate was 50.0% for "Because it is easy to participate if it is a learning opportunity by the insurer (e.g., health insurance association).

From these results, in terms of reasons for desirability of opportunities and timing to learn about prices, systems, and values, in terms of educational opportunities, "compulsory education" was favored for its free and equal access to everyone, and "compulsory education and high school education" was favored for its ease of finding time to learn, more opportunities to see a doctor alone, etc. and Compulsory education and upper secondary school education" was supported by the fact that it was free and equal for everyone. The "adult education" was considered to be an appropriate age to learn, as it is around the time when people begin to pay for medical care on their own. In addition to equal compulsory education, educational opportunities are desired at the age when people realize their involvement in medical care, such as when they receive medical examinations and pay medical bills, and it is clear that there is a wide range in the age range considered appropriate for learning. In addition, "transmission by pharmaceutical companies, etc." was supported as the most knowledgeable about medicine. Some respondents who had the opportunity to see their family doctor or pharmacy also expressed a desire to be taught by their family doctor or pharmacy.

5. summary

As in the previous paper, we have analyzed the expectations for knowing about the price, system, and value of drugs revealed in this survey, as well as the means, opportunities, and timing that are considered desirable, focusing on the characteristics of the group that values "non-medical value" realized as a spillover effect of treatment, etc. with drugs, and have described the results of this analysis. The following are the results of this analysis.

First, it can be said that the public has an expectation to know about the price, system, and value of pharmaceuticals. From the expectations, it was also found that in addition to an increase in their own awareness and interest, there is an expectation that their behavior when faced with medical care will also change, such as proper use of medicines and consultation with doctors and pharmacists. In addition, the higher probability of expectations in the groups that value "non-medical value," especially in Group 2, suggests that significant changes may be expected.

In terms of means of learning about prices, systems, and values, "TV" and "newspapers," which are generally trusted as means of obtaining information, as well as passive means through people, such as "hearing from doctors, nurses, pharmacists, and other medical professionals" and "learning in some setting, such as school education," are also desirable means for many people This was considered to be a desirable means for many people. Newspapers were the most preferred means of knowing about information among the "unemployed," "have a medical examination or disease," and "have a high level of subjective health," while electronic media such as "websites/apps," "community sites such as SNS and blogs," and "video sites such as YouTube" were the most preferred means of knowing about information among the "employed," "have a medical examination or disease," and "have a high level of subjective health," respectively. The survey also revealed differences by attribute, such as "employed persons" preferring "websites/apps," "community sites such as SNS and blogs," and "video sites such as YouTube. For the group that emphasized "value other than medical value," "learning about it in some setting, such as school education" and "websites/apps" were desired more, suggesting that "websites/apps" may also be effective in providing information to group 2.

As for opportunities and times to learn about prices, systems, and values, "school education (compulsory education)" and "school education (high school)" were considered desirable opportunities and times by many respondents, with "school education (compulsory education)" being selected for the attributes of "younger age" and "no medical examination or disease," and "school education (high school)" for "high final education" and " The attribute "small medical cost burden" was selected most frequently. The most frequently selected items were "communication from pharmaceutical companies, etc.," which was the third most frequently selected item when the most desirable opportunity or time was selected, suggesting that expectations were high, and it was selected most frequently by "female" and "low perceived health level" respondents. Even in Group 2, which emphasizes "values other than medical values," the respondents had high expectations for "transmissions from pharmaceutical companies, etc.," suggesting that they may pay attention to, trust, and have high expectations for "transmissions from pharmaceutical companies, etc." on a regular basis. Education in compulsory education and high school may be supported and expected by those who have little involvement in medical care (medical examinations and diseases), and those who have some concerns about their health may be supported and expected by those who have some concerns about their health by the transmission of information from pharmaceutical companies.

As for the reasons for choosing the opportunity and timing to learn about prices, systems, and values, "compulsory education" was supported for its free and equal access to everyone, and "compulsory and upper secondary school education" was considered an appropriate age to learn, along with the ease of securing time to learn and the increased opportunities to see a doctor alone, etc. It was also found that "transmission by pharmaceutical companies, etc." was selected as the "most knowledgeable about medicines," and that those who have the opportunity to see a doctor would like to be taught at their family doctor or family pharmacy, taking advantage of the opportunity to see a doctor.

In considering how to meet the expectations of people who want to know about the price, system, and value of drugs, it is necessary to determine the appropriate means, opportunities, and timing, taking into consideration the differences in requests by attribute and the reasons behind them, rather than lumping all people together.

6. conclusion

As shown in the Survey of Sei-katsu-sha Attitudes toward Drugs and the Pharmaceutical ^{Industry5) ,} a certain degree of "drug price structure (drug prices)" and "matters related to the healthcare system" were cited as information that the public would like to obtain, the public has an expectation to know about the prices, systems and values of drugs. And, if a deeper knowledge of these issues will not only increase their own awareness and interest, but also change their behavior in ways that may affect social issues such as public healthcare and insurance financing, there is no reason not to provide them with opportunities to learn more. According to "Health Literacy for the Future " ⁶⁾, informed decision making is the only decision that makes sense. In addition, it is necessary to change the environment itself in order to change individual behavior. It is not enough to simply inform the public how much the "drug price" is, but creating a pathway for the public to understand the price of drugs, the system (medical care at the time of consultation, drug prices related to drugs, medical insurance system, etc.), and value in general, while obtaining correct information, would be the first step toward making it highly convincing for the public. This is the first step toward making it more convincing to the public.

However, given that the public is not fully aware of the prices, systems, and values of ^drugs7) and that the drug price system, for example, is complicated and difficult to understand, it is important to consider steps to truly convey information and to make it easy to understand, such as by providing multiple opportunities to learn not just once, but in multiple layers and by multiple means that meet the needs of the public. It is also important to devise ways to communicate in a simple and easy-to-understand manner. In addition, the pharmaceutical industry must make a greater contribution by conveying correct information, taking into account the reality of the high ^{expectations8)} that have been placed on the industry.

In this analysis, we also found several characteristics of the groups that place importance on "values other than medical value" ("appropriate administration to patients," "productivity," "reintegration/return to work," "reduction in the burden of nursing care," and "reduction in the burden of healthcare professionals"). This is a group that has high expectations to know about prices, systems, and values, and may expect significant changes in their own attitudes, interests, and behaviors when faced with medical care. The survey also revealed that the respondents expect "websites, apps," and other tools that can be easily accessed in accordance with their individual lifestyles, as well as "information provided by pharmaceutical companies" as opportunities and timing. First, the pharmaceutical industry should start by providing information to groups that value these "non-medical values," not only through television and newspapers, but also through websites and applications, in order to deepen their understanding of these values, and also to provide information so that the public can broadly understand what these "non-medical values" are. The first step would be to provide information that will help the public better understand the value of pharmaceuticals.

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