Ethical Hurdles in the Prioritization of Oncology Care

Folkert Groot (), Stefano Capri, Jean-Claude Castanier, David Cunningham, Bruno Flamion, Mathias Flume, Harald Herholz, Lars-Åke Levin, Oriol Solà-Morales, Christoph J. Rupprecht, Natalie Shalet, Andrew Walker and Olivier Wong
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Folkert Groot: ToendersdeGroot B.V
Stefano Capri: LIUC University
Jean-Claude Castanier: Independent Consultant
David Cunningham: South East Commissioning Support Unit
Bruno Flamion: University of Namur
Mathias Flume: Kassenärztliche Vereinigung Westfalen Lippe
Harald Herholz: Kassenärztliche Vereinigung Hessen
Lars-Åke Levin: Linköping University
Oriol Solà-Morales: Health Institute for Technology Transfer (HITT)
Christoph J. Rupprecht: AOK Rheinland/Hamburg
Natalie Shalet: NAS Healthcare Solutions Ltd.
Andrew Walker: University of Glasgow
Olivier Wong: Mediqualité Omega

Applied Health Economics and Health Policy, 2017, vol. 15, issue 2, No 1, 119-126

Abstract: 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.

Date: 2017
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DOI: 10.1007/s40258-016-0288-4

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