NDLI: Høykostnadsmedisin--mangler vi åpne og legitime prosedyrer for prioritering?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Johansson, Kjell Arne Miljeteig, Ingrid Norheim, Ole Frithjof
Description	Author Affiliation: Johansson KA ( Fagområdet medisinsk etikk Institutt for samfunnsmedisinske fag Universitetet i Bergen, Postboks 78045020 Bergen. kjell.johansson@isf.uib.no)
Abstract	BACKGROUND: The gap between health needs and available resources leads to daily rationing decisions within the health system. We have explored whether procedures exist that can promote legitimate priority decisions in connection with implementation of new and expensive technology; implementation of new treatment regimes for colorectal cancer and breast cancer in Norway in 2005 are used as examples. MATERIAL AND METHODS: This is a qualitative case study. The theoretical framework: 'Accountability for reasonableness' was used to evaluate the introduction of the cancer drugs cetuximab (Erbitux) and trastuzumab (Herceptin). Data sources were official documents, newspaper articles and scientific publications with relevance to the priority setting debate concerning cetuximab and trastuzumab. RESULTS: Both cases illustrate hard choices with reasonable disagreements about values and data interpretation. The cases illustrate lack of publicity of both the decisions and their rationales. Cetuximab is less effective and costs more than trastuzumab. Weighting of cost and effect varied between the decision-makers. There are no formal mechanisms for appeals for patients who don't get the treatment they feel they are entitled to. INTERPRETATION: When these two priority cases were debated there were no established institutions or implemented procedures to facilitate an open and explicit priority setting procedure taking into consideration reasonable disagreement on substantive values.
File Format	HTM / HTML
ISSN	00292001
e-ISSN	08077096
Journal	Tidsskrift for Den norske legeforening
Issue Number	1
Volume Number	129
Language	Norwegian
Publisher	Norwegian Medical Association
Publisher Date	2009-01-01
Publisher Place	Norway
Access Restriction	Open
Subject Keyword	Discipline Medicine Decision Making Drug Costs Health Priorities Antibodies, Monoclonal Antibodies, Monoclonal, Humanized Antineoplastic Agents Cetuximab Cost-benefit Analysis Outcome Assessment (health Care) Resource Allocation Trastuzumab
Alternative Title	High-cost medicine--do we lack open and legitimate procedures for prioritising?
Content Type	Text
Resource Type	Article
Subject	Medicine

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Høykostnadsmedisin--mangler vi åpne og legitime prosedyrer for prioritering?