Supplementary file 1_The impact of risk information frameworks on cancer drug insurance (CDI) purchase decisions through time orientation and perceived risk: a survey-experiment study.docx

BackgroundChina is actively promoting cancer drugs insurance (CDI) to alleviate the growing burden of cancer. However, the efficacy of risk information frameworks supplied to consumers in expanding CDI coverage remains poorly understood.
PurposeThis study aimed to examine the impact of the risk information framework (RIF) on individuals’ CDI purchase decisions, as well as the roles played by time orientation and perceived risk within these frameworks.
MethodsThis nationwide online survey enrolled 5,583 eligible participants aged from 18 to 60 years old in August 2025 in China. A randomized survey-based experiment with the designed risk information frameworks was conducted to elicit CDI purchase decisions. Participants were exposed to either a low-risk information framework (LRIF) or a high-risk information framework (HRIF) before making CDI purchase decisions. Descriptive statistics and mediating effect models were used to analyze participants’ decisions to purchase CDI.
ResultsAmong 2,825 eligible participants in LRIF, 364 (12.9%) were not insured by CDI, and 1,507 (53.3%) were insured by long-term CDI schemes (selected the option of 3 years). Among 2,758 eligible participants in HRIF, 99 (3.6%) were not insured by CDI, and 1881 (68.2%) were insured by long-term CDI schemes. Under LRIF, the mediating effects of perceived risk between present-oriented attitude and CDI purchase were −0.030 [95%CI: −0.072, −0.003], and between future-oriented attitude and CDI purchase were 0.089 [95%CI: 0.064, 0.118]. Under HRIF, the corresponding mediating effects of perceived risk were −0.006 [95%CI: −0.024, −0.001] and 0.022 [95%CI: 0.010, 0.038].
ConclusionHRIF could stimulate an individual’s CDI adoption. The underlying mechanism may be that HRIF restrains a present-oriented attitude and reinforces a future-oriented one, with perceived risk as a mediating factor. These findings underscore the need to emphasize RIF designs to promote CDI coverage.

研究背景
中国正积极推进癌症药品保险（cancer drugs insurance, CDI）以缓解日益加重的癌症疾病负担。然而，面向消费者提供的风险信息框架（risk information framework, RIF）对于扩大CDI覆盖范围的实际效果仍未得到充分探明。

研究目的
本研究旨在考察风险信息框架（RIF）对个体癌症药品保险购买决策的影响，以及时间取向与感知风险在该框架作用中所扮演的中介角色。

研究方法
本研究于2025年8月在中国开展一项全国性线上调查，共招募5583名年龄介于18至60岁的合格受试者。研究采用基于调查问卷的随机对照实验，通过设计不同的风险信息框架来获取受试者的CDI购买意愿：受试者在做出CDI购买决策前，将被随机分配至低风险信息框架（low-risk information framework, LRIF）组或高风险信息框架（high-risk information framework, HRIF）组。本研究采用描述性统计与中介效应模型对受试者的CDI购买决策数据进行分析。

研究结果
在低风险信息框架组的2825名合格受试者中，364人（12.9%）未投保CDI，1507人（53.3%）选择了投保期限为3年的长期CDI方案；在高风险信息框架组的2758名合格受试者中，99人（3.6%）未投保CDI，1881人（68.2%）选择了长期CDI方案。在低风险信息框架条件下，感知风险在当下取向态度与CDI购买行为间的中介效应为-0.030[95%置信区间：-0.072，-0.003]，在未来取向态度与CDI购买行为间的中介效应为0.089[95%置信区间：0.064，0.118]；在高风险信息框架条件下，感知风险对应的中介效应分别为-0.006[95%置信区间：-0.024，-0.001]与0.022[95%置信区间：0.010，0.038]。

研究结论
高风险信息框架可有效提升个体的CDI投保意愿，其潜在作用机制可能为：高风险信息框架能够抑制个体的当下取向态度，同时强化其未来取向态度，而感知风险在此过程中发挥中介作用。本研究结果凸显了优化风险信息框架设计以扩大CDI覆盖范围的必要性。