보건행정학회지 (Health Policy and Management)

  • 제16권2호
  • /
  • Pages.96-116
  • /
  • 2006
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  • 1225-4266(pISSN)
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  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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크레메진의 만성신부전증 환자 투석도입 지연효과에 대한 최대지불의사액(willingness-to-pay) 추청

Estimating willingness-to-pay for Kremezin in delaying the initiation of dialysis treatments among patients with chronic renal failure

  • 이선미 (연세대학교 대학원 보건학과) ;
  • 문연옥 (국립암센터 지역암센터지원연구과) ;
  • 조우현 (연세대학교 의과대학 예방의학교실) ;
  • 이후연 (연세대학교 보건대학원) ;
  • 강혜영 (연세대학교 보건대학원)
  • Lee Sun-Mi (Department of Public Health, Yonsei University) ;
  • Mun Youn-Ok (Regional Cancer Center Branch, National Cancer Center) ;
  • Cho Woo-Hyun (Department of Preventive Medicine, College of Medicine, Yonsei University) ;
  • Lee Hoo-Yeon (Graduate School of Public Health, Yonsei University) ;
  • Kang Hye-Young (Graduate School of Public Health, Yonsei University)
  • 발행 : 2006.06.01
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초록

To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.

키워드

참고문헌

  1. 건강보험심사평가원. 혈액투석수가 정액화 방안에 대한 검토 보고서. 서울:건강보험심사평가원;2002
  2. 권미수, 김기환, 송영웅. 정보서비스의 가치측정방법론 연구: 조건부가치측정법을 중심으로. 서울:한국전산원;2004
  3. 김진철, 조성태, 윤종우, 김근호, 전노원, 김형직 등. 유지 혈액투석환자에서의 우울증 발생의 위험인자 및 우울중이 영양지표에 미치는 영향. 대한내과학회지 2002;62(1):77-82
  4. 대한신장학회 등록위원회. 우리나라 신대체 요법의 현황-인산 민병석 교수 기념 말기신부전환자 동록사업 2003. 대한신장학회지 2004;23(s2):s381-s404
  5. 민현조, 고경식, 김명식, 문성수, 박원도, 박철휘 등. 혈액투석환자의 삶의 질에 대한 연구. 대한신장학회지 1999;18;(5):714-732
  6. 양봉민, 김윤미, 김진현, 반덕진, 유왕근, 배은영. 의약분업의 경제성 평가. 서울:서울대학교 보건대학원;1998
  7. 이태진. 약물경제성 평가 현황과 제도 도입방향. 주요 외국의 '약물경제성평가 및 성과연구' 현황과 시사점에 대한 국제심포지엄. 서울:한국보건사회연구원;2003
  8. Chizuru I, Michiko K, Sanae I .Estimating the effect of oral adsorbent AST-120 on delay of the initiation of dialysis in patients with chronic renal failure. Progress in Medicine 2000;20:2047-2050 (Japanese)
  9. Cross MJ, March LM, Lapsley HM, Tribe KL, Brnabic AJ, Courtenay BG, et al. Determinants of willingness to pay for hip and knee joint replacement surgery for osteoathritis. Rheumatology Oxford 2000;39:1242-8 https://doi.org/10.1093/rheumatology/39.11.1242
  10. Davis R. Recreation planning as an economic problem. Nat Resour J 1963:3:239-249
  11. Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford Medical Publications;1997a
  12. Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Ch. 7. Cost-benefit analysis. In: Methods for the economic evaluation of health care programmes. 2nd ed. Oxford: Oxofrd University Press 1997b. pp.226
  13. Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Ch. 7. Cost-benefit analysis. In: Methods for the economic evaluation of health care programmes. 2nd ed. Oxford:Oxford University Press; 1997c. pp.218
  14. Fautrel B, Clarke AE, Guillemin F, Adam V, St- Pierre Y, Panaritis T, et al. Valuing a hypothetical cure for rheumatoid arthritis using the contingent valuation methodology: the patient perspective. J Rheumatol 2005; 32(3):434-53
  15. Gafni A, Feder A. Willingness to pay in an equitable society: the case of the Kibbutz. Int J Soc Econ 1987;14:16-21 https://doi.org/10.1108/eb014033
  16. Jampel RD, Parekh P, Johnson E, Robin AL, Miller RB. Preferences for eye drop characteristics among glaucoma specialists: a willingness-to-pay analysis. J Glaucoma 2005;14(2):151-6 https://doi.org/10.1097/01.ijg.0000151879.14855.ea
  17. KIose T. The contingent valuation method in health care. Health Policy 1999; 47: 97-123 https://doi.org/10.1016/S0168-8510(99)00010-X
  18. Lenert LA. Use of willingness to pay to study values for pharmacotherapies for migraine headache. Med Care 2003;41(2):299-308 https://doi.org/10.1097/00005650-200302000-00011
  19. Luckmann J, Sorensen KC. Medical-Surgical nursing. 3rd ed. Philadelphia:W.B. Saunders Co.; 1987
  20. Majkowicz M, Afeltowicz Z, Lichodziejewska-Niemierko M, Debska-Slizien A, Rutkowski B. Comparison of the quality of life in hemodialysed (HD) and peritoneally dialysed (CAPD) patients using the EORTC QLQ-C30 questionnaire. Int J Artif Organs 2000;23(7):423-428 https://doi.org/10.1177/039139880002300703
  21. Motojima M, Nishijima F, Ikoma M, Kawamura T, Yoshioka T, Fogo AB, et al. Role for 'uremic toxin' in the progressive loss of intact nephrons in chronic renal failure. Kidney Int 1991;40(3):461-469 https://doi.org/10.1038/ki.1991.233
  22. Naoki M, Hidetaka N, Katsutoshi K. Effect of oral adsorbent on diabetic renal failure patients with relation to level of serum bete-2-microglobulin at the time of first prescription of the drug. Kidney and Dialysis 2002;53(3):397-402 (Japanese)
  23. Niwa T, Ise M Indoxyl sulfate, a circulating uremic toxin, stimulate the progression of glomerular sclerosis. J Lab Clin Med 1994;124(1):96-104
  24. Niwa T, Nomura T, Sugiyama S, Miyazaki T, Tsulrushi S, Tsutshi S. The protein metabolite hypothesis, a model for the progression of renal failure: an oral adsorbent lowers indoxylsulfate levels in undialyzed uremic patients. Kidney Int 1997;62:23-28
  25. O'Brien B, Novosel S, Torrance G, Streiner D. Assessing the economic value of a new antidepressant A willingness-to-pay approach. Pharmacoeconomics 1995;8:34-45 https://doi.org/10.2165/00019053-199508010-00006
  26. Owada A, Shiigai T. Effects of oral adsorbent AST-120 concurrent with a low-protein diet on the progression of chronic renal failure. Am J Nephrol 1996;16:124-127 https://doi.org/10.1159/000168983
  27. Owada A, Nakao.M, Koike J, Ujiie K, Tomita K, Shiigai T. Effect of oral adsorbent AST-120 on the progression of chronic renal failure: A randomized controlled study. Kidney Int 1997;63:S188-S190
  28. Portney PR. The contingent valuation debate: why economists should care. J Econ Perspct 1994;8(4):3-17
  29. Rydholm L, Pauling J. Contrasting feelings of helplessness in peritoneal and hemodialysis patients: a pilot study. ANNA J 1991;18(2):183-186
  30. Sach TH, Whynes DK, O'Neill C, O'Donoghue GM, Archbold SM. Willingness-to-pay for pediatric cochlear implantation. Int J Pediatr Otorhinolaryngol 2004;68(1):91-99 https://doi.org/10.1016/j.ijporl.2003.09.009
  31. Shoze K, Keizo K, Yoshiji Y. The effect of AST-120 on delaying initiation of dialysis therapy in end-stage renal disease. Dialysis 1992;32(5):191-130 (Japanese)
  32. Simmons RG, Anderson CR, Abress LK. Quality of life and rehabilitation differences among four end-stage renal disease therapy groups. Scand J Urol Nephrol Suppl 1990;131:7-22
  33. Thompson MS, Read JL, Liang M. Willingness-to-pay concepts for societal decisions in health. In: Kane RL, Kane RA, editors. Values and long-term care. Toronto: Lexington 1982. pp.103-25
  34. Thompson MS, Read JL, Liang M. Feasibility of willingness-to-pay measurement in chronic arthritis. Med Decis Making 1984;4:195-215 https://doi.org/10.1177/0272989X8400400207
  35. Yorioka N, Ito T, Masaki T, Ogata S, Asakimori Y, Tanji C, et al. Dose-dependent effect of an oral adsorbent, AST-120, in patients with early chronic renal failure. J Int Med Res 2002;30:467-475 https://doi.org/10.1177/147323000203000501
  36. Yoshida Y, Sakai T, Ise M. Effects of oral adsorbent in the rat model of chronic renal failure. Nephron 1992;62(3):305-314 https://doi.org/10.1159/000187065
  37. Yoshinobu T, Toshio O, Norihiro S. Effect of Kremezinon diabetic renal failure. Journal of Practical Diabetes 2003;20(6):721-725 (Japanese)