Priority Setting in Health Care:Matching Decision Criteria with Policy Objectives

Brinsmead, Gina; Williams, Alan

doi:10.1002/9780470994719.ch7

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Applying the opportunity-cost principle 82 should maximize welfare for the whole population. Sacrificing the principle may be seen as an admirable human response to the plight of an identifiable individual who will die if she does not receive treatment, but the cumulative effect of repeatedly applying the rule of rescue will lower the average level of population benefit, 83 something Goodin describes as 'unthinking, irresponsible behaviour at an institutional level'. 84 However rational the arguments may be that '[p]olitical pressure, patient advocacy, and media hyperbole should not determine who is treated and what they are treated with', this Australian case exemplifies how the rule of rescue can bulldoze rapid changes in health policy.…”

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confidence: 99%

Media influence on Herceptin subsidization in Australia: application of the rule of rescue?

et al. 2008

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Summary Background In August 2006, the Australian government announced that Herceptin (Trastuzumab) would be added to the national Pharmaceutical Benefits Scheme (PBS) of government-subsidized drugs, for treatment with adjuvant chemotherapy of HER2 breast cancer. Following initial reticence, the health minister responded to a campaign by patients and patient advocacy groups by announcing PBS subsidization which lowered the cost of a weekly dose from A$1000 to A$30. The cost to the government would be A$470 million over three years for treatment of an estimated 2100 women annually. Design We analysed the news frames used in all direct and attributed statements ( n=239) in television news coverage of the discourse preceding the Herceptin decision by the Australian government. Setting Five Sydney free-to-air channels between October 2005 and August 2006. Main outcome measures News frames or themes. Results Of five news frames identified, one (‘desperate, sick women in double jeopardy because of callous government/incompetent bureaucracy’) accounted for 54% of all reported statements. Government financial parsimony was framed as responsible for the women's plight, with drug industry pricing never mentioned. Claimed benefits of Herceptin often conflated cancer non-recurrence and survival and favoured quantification rhetoric which emphasized percentage increases in improvement rather than the more modest increases in absolute survival. Conclusions News frames invoking key tenets of the ‘rule of rescue’ dominated television discourse on Herceptin. Clinicians, patients, their families and patient advocacy groups invoking the rule of rescue can increase the likelihood of achieving their objective of gaining access to expensive healthcare such as pharmaceuticals. Rational, criteria-based public health policy will find it hard to resist the rule of rescue imperative.

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confidence: 99%

Media influence on Herceptin subsidization in Australia: application of the rule of rescue?

et al. 2008

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“…In particular, the argument that anti-ageing research should not have priority on public resources until people everywhere have a fair chance of living long enough to benefit from it, seems to me to be a valid argument, and acting on it would be consistent with equitable resource distribution. (Brinsmead and Williams, 2004;Daniels and Sabin, 2002;Seabright, 1993) .…”

Section: Ethical Aspects Of Anti-ageing Science -A Point Of Viewmentioning

confidence: 99%

Anti-Ageing Medicine: Myths and Chances

Stückelberger¹

2008

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“…The notable exception was Iran (a country with a young population) where participants ranked caregiver support midway (rank 5). For countries other than Iran, it may be that survey respondents adopted the “fair innings” principle whereby someone who has already had a fair innings, say a fit elderly person, gets lower priority for health-care spending than a young person who, “without treatment, will certainly not reach the societal norm (through premature death and/or lifelong disability)” [11]. What's not obvious from the results is the degree to which participants regard reducing health inequality as more important than achieving a health maximisation objective.…”

Section: Key Valuesmentioning

confidence: 99%

What Drives Health-Care Spending Priorities? An International Survey of Health-Care Professionals

Salkeld¹,

Henry²,

Hill³

et al. 2007

PLoS Med

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Priority Setting in Health Care:Matching Decision Criteria with Policy Objectives

Cited by 5 publications

References 26 publications

Media influence on Herceptin subsidization in Australia: application of the rule of rescue?

Media influence on Herceptin subsidization in Australia: application of the rule of rescue?

Anti-Ageing Medicine: Myths and Chances

What Drives Health-Care Spending Priorities? An International Survey of Health-Care Professionals

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