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Funding and access to high cost medicines in public hospitals in Australia: Decision-makers' perspectives

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

Abstract

Aim To investigate the perceptions, concerns and attitudes of decision-makers regarding access to high cost medicines (HCMs) in public hospitals.Methods In-depth semi-structured interviews were conducted with 24 decisions-makers (executive directors of hospitals, area health service managers, directors of hospital pharmacy departments and senior medical doctors) in a Sydney Area Health Service. The interviews were digitally recorded and transcribed and analysed using a modified grounded theory approach.Results Decision-makers perceived health care system funding models as obstacles to equity of access to HCMs. They were concerned that there were inequities in decisions for individual patients according to public or private sector status. A major concern for respondents was the lack of consistency in decision-making about funding for HCMs. Respondents described that besides safety, efficacy, effectiveness and cost, ethical principles should be borne in mind when deciding whether a HCM should be available in a public hospital. Most wanted a consistent, transparent, accountable, evidence-based decision-making process.Conclusions The results of this study suggest that decision-makers were concerned about the equity of access to HCMs in public hospitals and wanted an explicit, systematic process to allocate resources to HCMs.

Suggested Citation

  • Gallego, Gisselle & Taylor, Susan Joyce & Brien, Jo-anne Elizabeth, 2009. "Funding and access to high cost medicines in public hospitals in Australia: Decision-makers' perspectives," Health Policy, Elsevier, vol. 92(1), pages 27-34, September.
  • Handle: RePEc:eee:hepoli:v:92:y:2009:i:1:p:27-34
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    References listed on IDEAS

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    1. Productivity Commission, 2005. "Impacts of Advances in Medical Technology in Australia," Research Reports, Productivity Commission, Government of Australia, number 17.
    2. Victor R. Fuchs, 2018. "Economics, Values, and Health Care Reform," World Scientific Book Chapters, in: Health Economics and Policy Selected Writings by Victor Fuchs, chapter 39, pages 497-531, World Scientific Publishing Co. Pte. Ltd..
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    1. Whitty, Jennifer A. & Littlejohns, Peter, 2015. "Social values and health priority setting in Australia: An analysis applied to the context of health technology assessment," Health Policy, Elsevier, vol. 119(2), pages 127-136.
    2. Grover, Piyush & Babar, Zaheer-Ud-Din & Oehmen, Raoul & Vitry, Agnes, 2018. "Medicines access programs to cancer medicines in Australia and New Zealand: An exploratory study," Health Policy, Elsevier, vol. 122(3), pages 243-249.
    3. Prilepskiy, Ilya (Прилепский, Илья), 2017. "Factors of Exports Dynamics and Import Substitution after the Sharp Exchange Rate Depreciation [Факторы Динамики Экспорта И Импортозамещения После Резкого Ослабления Курса Национальной Валюты]," Ekonomicheskaya Politika / Economic Policy, Russian Presidential Academy of National Economy and Public Administration, vol. 3, pages 100-133, June.

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