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Appl Health Econ Health Policy. 2017 Apr;15(2):119-126. doi: 10.1007/s40258-016-0288-4.

Ethical Hurdles in the Prioritization of Oncology Care.

Author information

1
ToendersdeGroot B.V, Boomstede 281, 3608 AN, Maarssen, The Netherlands. fgroot@toendersdegroot.nl.
2
School of Economics and Management, LIUC University, Castellanza, Italy.
3
Independent Consultant, Bandol, France.
4
South East Commissioning Support Unit, London, UK.
5
University of Namur, Namur, Belgium.
6
Kassenärztliche Vereinigung Westfalen Lippe, Dortmund, Germany.
7
Kassenärztliche Vereinigung Hessen, Frankfurt, Germany.
8
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
9
Health Institute for Technology Transfer (HITT), Barcelona, Spain.
10
AOK Rheinland/Hamburg, Düsseldorf, Germany.
11
NAS Healthcare Solutions Ltd., Surbiton, UK.
12
University of Glasgow, Glasgow, UK.
13
Mediqualité Omega, Paris, France.

Abstract

With finite resources, healthcare payers must make difficult choices regarding spending and the ethical distribution of funds. Here, we describe some of the ethical issues surrounding inequity in healthcare in nine major European countries, using cancer care as an example. To identify relevant studies, we conducted a systematic literature search. The results of the literature review suggest that although prevention, access to early diagnosis, and radiotherapy are key factors associated with good outcomes in oncology, public and political attention often focusses on the availability of pharmacological treatments. In some countries this focus may divert funding towards cancer drugs, for example through specific cancer drugs funds, leading to reduced expenditure on other areas of cancer care, including prevention, and potentially on other diseases. In addition, as highly effective, expensive agents are developed, the use of value-based approaches may lead to unacceptable impacts on health budgets, leading to a potential need to re-evaluate current cost-effectiveness thresholds. We anticipate that the question of how to fund new therapies equitably will become even more challenging in the future, with the advent of expensive, innovative, breakthrough treatments in other therapeutic areas.

PMID:
27766548
PMCID:
PMC5343076
DOI:
10.1007/s40258-016-0288-4
[Indexed for MEDLINE]
Free PMC Article

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