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

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 allocat...

Full description

Saved in:
Bibliographic Details
Published in:Health policy (Amsterdam) 2007-11, Vol.84 (1), p.58-66
Main Authors: Gallego, Gisselle, Taylor, Susan Joyce, Brien, Jo-anne Elizabeth
Format: Article
Language:English
Subjects:
Australia
Case study
Costs
Decision Making
Health administration
Health care
Health costs
Health Priorities
Hospitals
Hospitals, Public
Humans
Internal Medicine
Interviews as Topic
National Health Programs - economics
New South Wales
Organizational Case Studies
Patients
Pharmaceutical Preparations - economics
Pharmaceuticals
Pharmaceuticals Decision-making Case study Australia
Prescriptions
Public health care
Resource allocation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2007.05.008