Box 1 Hypothetical scenario presented to the respondents

Briefly, mRNA technology is one of the outcomes of research on the human genome. Prior to the COVID-19 pandemic, mRNA had little practical medical use. At the end of 2020, the leading health authorities in the U.S. (FDA) and Europe (EMA) approved the commercialization of Pfizer’s and Moderna’s Covid-19 vaccination based on this technology. These are the vaccines used in Israel.

Now imagine the following theoretical scenario: you contact your general practitioner with complaints about pain and fatigue. After a series of tests, the GP tells you that you have advanced melanoma (skin cancer), lung cancer, breast/ovarian cancer or cancer of the digestive system. In terms of treatment options, the physician suggests either immunotherapy (medication that boosts the body's natural immunization system to fight the tumor), or a combination of immunotherapy and mRNA technology. The first, which is fully reimbursed by your health fund, has a 20% chance of 5-year survival. The addition of mRNA treatment, which is not covered by the basic health insurance package, has been approved by health regulatory authorities in the US (FDA) and in Europe (EMA). It is expected to lead from the current 20% survival rate to a 40% chance of 5-year survival (for half of the respondents)/60% (for the other half of respondents).

Both treatments are administered once a month in the hospital and have a similar adverse events profile. If you are interested in the second option, you will have to pay for it out of your own pocket regardless of your health plan or complementary private insurance you may have.

Would you agree to pay XXX (*) to cover the annual expense for f new treatment, which is not covered by your health insurance?

 1) Yes

 2) No, but I would be willing to pay a lesser amount

 3) No, I would not be willing to pay any amount