IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v84y2007i1p58-66.html
   My bibliography  Save this article

Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study

Author

Listed:
  • Gallego, Gisselle
  • Taylor, Susan Joyce
  • Brien, Jo-anne Elizabeth

Abstract

Health care providers (HCPs) are increasingly aware of pressures on funding for health care services, including high cost medicines (HCMs). Allocating resources to innovative and expensive medications is particularly challenging and the decision-making processes and criteria used to allocate resources to HCMs have not been widely described in the literature. This case study aimed to describe the operations of the first reported High Cost Drug Sub-Committee (HCD-SC) in a public hospital in Australia. In addition the study also evaluated the decision-making process using Daniel and Sabin's ethical framework of "accountability for reasonableness". Some lessons emerged from the description of the operations of the HCD-SC. Decisions were not solely based on effectiveness and cost. Additional factors such as "clinical need" and the lack of an alternative treatment were involved in decisions about access to HCMs. Members of the HCD-SC also considered it was important to have consistency in the way decisions were being made. The findings from this study provide an evidence base for developing strategies to improve this hospital's decision-making process regarding access to HCMs.

Suggested Citation

  • Gallego, Gisselle & Taylor, Susan Joyce & Brien, Jo-anne Elizabeth, 2007. "Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study," Health Policy, Elsevier, vol. 84(1), pages 58-66, November.
    • Handle: RePEc:eee:hepoli:v:84:y:2007:i:1:p:58-66
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(07)00123-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Martin, Douglas K. & Giacomini, Mita & Singer, Peter A., 2002. "Fairness, accountability for reasonableness, and the views of priority setting decision-makers," Health Policy, Elsevier, vol. 61(3), pages 279-290, September.
    2. Daniels, Norman & Sabin, James E., 2002. "Setting Limits Fairly: Can we learn to share medical resources?," OUP Catalogue, Oxford University Press, number 9780195149364, Decembrie.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jeannette Winkelhage & Adele Diederich, 2012. "The Relevance of Personal Characteristics in Allocating Health Care Resources—Controversial Preferences of Laypersons with Different Educational Backgrounds," IJERPH, MDPI, vol. 9(1), pages 1-21, January.
    2. Kapiriri, Lydia & Razavi, Donya, 2017. "How have systematic priority setting approaches influenced policy making? A synthesis of the current literature," Health Policy, Elsevier, vol. 121(9), pages 937-946.
    3. Jana Rogge & Bernhard Kittel, 2016. "Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-15, June.
    4. Gallagher, Siun & Little, Miles, 2019. "Procedural justice and the individual participant in priority setting: Doctors' experiences," Social Science & Medicine, Elsevier, vol. 228(C), pages 75-84.
    5. Douglas, Conor M.W. & Wilcox, Elizabeth & Burgess, Michael & Lynd, Larry D., 2015. "Why orphan drug coverage reimbursement decision-making needs patient and public involvement," Health Policy, Elsevier, vol. 119(5), pages 588-596.
    6. Brayan V. Seixas & François Dionne & Craig Mitton, 2021. "Practices of decision making in priority setting and resource allocation: a scoping review and narrative synthesis of existing frameworks," Health Economics Review, Springer, vol. 11(1), pages 1-11, December.
    7. Dale, Elina & Peacocke, Elizabeth F. & Movik, Espen & Voorhoeve, Alex & Ottersen, Trygve & Kurowski, Christoph & Evans, David B. & Norheim, Ole Frithjof & Gopinathan, Unni, 2023. "Criteria for the procedural fairness of health financing decisions: a scoping review," LSE Research Online Documents on Economics 119799, London School of Economics and Political Science, LSE Library.
    8. Jennifer Whitty & Sharyn Rundle-Thiele & Paul Scuffham, 2012. "Insights from triangulation of two purchase choice elicitation methods to predict social decision making in healthcare," Applied Health Economics and Health Policy, Springer, vol. 10(2), pages 113-126, March.
    9. Rosenberg-Yunger, Zahava R.S. & Daar, Abdallah S. & Thorsteinsdóttir, Halla & Martin, Douglas K., 2011. "Priority setting for orphan drugs: An international comparison," Health Policy, Elsevier, vol. 100(1), pages 25-34, April.
    10. Lesley Chim & Glenn Salkeld & Patrick Kelly & Wendy Lipworth & Dyfrig A Hughes & Martin R Stockler, 2017. "Societal perspective on access to publicly subsidised medicines: A cross sectional survey of 3080 adults in Australia," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-24, March.
    11. Adele Diederich & Jeannette Winkelhage & Norman Wirsik, 2011. "Age as a Criterion for Setting Priorities in Health Care? A Survey of the German Public View," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-10, August.
    12. Rosenberg-Yunger, Zahava R.S. & Thorsteinsdóttir, Halla & Daar, Abdallah S. & Martin, Douglas K., 2012. "Stakeholder involvement in expensive drug recommendation decisions: An international perspective," Health Policy, Elsevier, vol. 105(2), pages 226-235.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Reeleder, David & Goel, Vivek & Singer, Peter A. & Martin, Douglas K., 2006. "Leadership and priority setting: The perspective of hospital CEOs," Health Policy, Elsevier, vol. 79(1), pages 24-34, November.
    2. Gibson, Jennifer L. & Martin, Douglas K. & Singer, Peter A., 2005. "Priority setting in hospitals: Fairness, inclusiveness, and the problem of institutional power differences," Social Science & Medicine, Elsevier, vol. 61(11), pages 2355-2362, December.
    3. Maluka, Stephen & Kamuzora, Peter & Sebastiån, Miguel San & Byskov, Jens & Olsen, Øystein E. & Shayo, Elizabeth & Ndawi, Benedict & Hurtig, Anna-Karin, 2010. "Decentralized health care priority-setting in Tanzania: Evaluating against the accountability for reasonableness framework," Social Science & Medicine, Elsevier, vol. 71(4), pages 751-759, August.
    4. Regier, Dean A. & Bentley, Colene & Mitton, Craig & Bryan, Stirling & Burgess, Michael M. & Chesney, Ellen & Coldman, Andy & Gibson, Jennifer & Hoch, Jeffrey & Rahman, Syed & Sabharwal, Mona & Sawka, , 2014. "Public engagement in priority-setting: Results from a pan-Canadian survey of decision-makers in cancer control," Social Science & Medicine, Elsevier, vol. 122(C), pages 130-139.
    5. Kapiriri, Lydia & Norheim, Ole F. & Martin, Douglas K., 2009. "Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?," Social Science & Medicine, Elsevier, vol. 68(4), pages 766-773, February.
    6. Madden, Shannon & Martin, Douglas K. & Downey, Sarah & Singer, Peter A., 2005. "Hospital priority setting with an appeals process: a qualitative case study and evaluation," Health Policy, Elsevier, vol. 73(1), pages 10-20, July.
    7. Mitton, Craig R. & McMahon, Meghan & Morgan, Steve & Gibson, Jennifer, 2006. "Centralized drug review processes: Are they fair?," Social Science & Medicine, Elsevier, vol. 63(1), pages 200-211, July.
    8. Vuorenkoski, Lauri & Toiviainen, Hanna & Hemminki, Elina, 2003. "Drug reimbursement in Finland--a case of explicit prioritising in special categories," Health Policy, Elsevier, vol. 66(2), pages 169-177, November.
    9. Klerkx, Laurens & Leeuwis, Cees, 2008. "Institutionalizing end-user demand steering in agricultural R&D: Farmer levy funding of R&D in The Netherlands," Research Policy, Elsevier, vol. 37(3), pages 460-472, April.
    10. Askildsen, Jan Erik & Holmås, Tor Helge & Kaarboe, Oddvar, 2010. "Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian hospital sector," Social Science & Medicine, Elsevier, vol. 70(2), pages 199-208, January.
    11. Sofaer, Neema & Kapiriri, Lydia & Atuyambe, Lynn M. & Otolok-Tanga, Erasmus & Norheim, Ole Frithjof, 2009. "Is the selection of patients for anti-retroviral treatment in Uganda fair?: A qualitative study," Health Policy, Elsevier, vol. 91(1), pages 33-42, June.
    12. Salome A. Bukachi & Washington Onyango-Ouma & Jared Maaka Siso & Isaac K. Nyamongo & Joseph K. Mutai & Anna Karin Hurtig & Øystein Evjen Olsen & Jens Byskov, 2014. "Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework," International Journal of Health Planning and Management, Wiley Blackwell, vol. 29(4), pages 342-361, October.
    13. Gallagher, Siun & Little, Miles, 2019. "Procedural justice and the individual participant in priority setting: Doctors' experiences," Social Science & Medicine, Elsevier, vol. 228(C), pages 75-84.
    14. Jenny von Platten & Karl de Fine Licht & Mikael Mangold & Kristina Mjörnell, 2021. "Renovating on Unequal Premises: A Normative Framework for a Just Renovation Wave in Swedish Multifamily Housing," Energies, MDPI, vol. 14(19), pages 1-32, September.
    15. Chris Sampson & Bernarda Zamora & Sam Watson & John Cairns & Kalipso Chalkidou & Patricia Cubi-Molla & Nancy Devlin & Borja García-Lorenzo & Dyfrig A. Hughes & Ashley A. Leech & Adrian Towse, 2022. "Supply-Side Cost-Effectiveness Thresholds: Questions for Evidence-Based Policy," Applied Health Economics and Health Policy, Springer, vol. 20(5), pages 651-667, September.
    16. Jennifer Whitty & Paul Scuffham & Sharyn Rundle-Thielee, 2011. "Public and decision maker stated preferences for pharmaceutical subsidy decisions," Applied Health Economics and Health Policy, Springer, vol. 9(2), pages 73-79, March.
    17. Axel C. Mühlbacher & John F. P. Bridges & Susanne Bethge & Ch.-Markos Dintsios & Anja Schwalm & Andreas Gerber-Grote & Matthias Nübling, 2017. "Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 155-165, March.
    18. Brayan V. Seixas & François Dionne & Craig Mitton, 2021. "Practices of decision making in priority setting and resource allocation: a scoping review and narrative synthesis of existing frameworks," Health Economics Review, Springer, vol. 11(1), pages 1-11, December.
    19. M. Sirgy & Dong-Jin Lee & Grace Yu, 2011. "Consumer Sovereignty in Healthcare: Fact or Fiction?," Journal of Business Ethics, Springer, vol. 101(3), pages 459-474, July.
    20. Armstrong, Kristy & Mitton, Craig & Carleton, Bruce & Shoveller, Jean, 2008. "Drug formulary decision-making in two regional health authorities in British Columbia, Canada," Health Policy, Elsevier, vol. 88(2-3), pages 308-316, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:84:y:2007:i:1:p:58-66. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.