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

Gisselle Gallego1, Susan Joyce Taylor, Jo-Anne Elizabeth Brien

  • 1Centre for Health Economics Research and Evaluation (CHERE), University of Technology, Sydney, PO Box 123, Broadway, NSW 2007, Australia. gisselle.gallego@chere.uts.edu.au

Health Policy (Amsterdam, Netherlands)
|July 10, 2007
PubMed

Insights

Health care providers face funding challenges for high cost medicines (HCMs). Decisions on HCM access consider clinical need and treatment alternatives, not just cost and effectiveness, ensuring equitable resource allocation.

Area of Science:

  • Health economics
  • Pharmaceutical policy
  • Medical ethics

Background:

  • Healthcare providers face increasing financial pressures on health services.
  • Allocating resources for high cost medicines (HCMs) presents significant challenges.
  • Decision-making processes for HCM resource allocation are not well-documented.

Purpose of the Study:

  • To describe the operations of the first High Cost Drug Sub-Committee (HCD-SC) in an Australian public hospital.
  • To evaluate the HCD-SC's decision-making process using the "accountability for reasonableness" ethical framework.

Main Methods:

  • Case study methodology.
  • Description of the operational procedures of the HCD-SC.
  • Evaluation of decision-making criteria using a recognized ethical framework.

Main Results:

  • HCD-SC decisions incorporated factors beyond effectiveness and cost, including clinical need and availability of alternative treatments.
  • Consistency in decision-making was a key consideration for HCD-SC members.
  • The study provides insights into the practical application of ethical frameworks in resource allocation.

Conclusions:

  • Hospital-based drug committees utilize multifaceted criteria for HCM access decisions.
  • Ethical frameworks can guide resource allocation for expensive medications.
  • Findings can inform strategies to optimize decision-making processes for HCM access.

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