BACKGROUND: In August 2006, the Australian government announced that Herceptin (Trastuzumab) would be added to the national Pharmaceutical Benefits Scheme (PBS) of government-subsidized drugs, for treatment with adjuvant chemotherapy of HER2 breast cancer. Following initial reticence, the health minister responded to a campaign by patients and patient advocacy groups by announcing PBS subsidization which lowered the cost of a weekly dose from A$1000 to A$30. The cost to the government would be A$470 million over three years for treatment of an estimated 2100 women annually. DESIGN: We analysed the news frames used in all direct and attributed statements (n=239) in television news coverage of the discourse preceding the Herceptin decision by the Australian government. SETTING: Five Sydney free-to-air channels between October 2005 and August 2006. MAIN OUTCOME MEASURES: News frames or themes. RESULTS: Of five news frames identified, one ('desperate, sick women in double jeopardy because of callous government/incompetent bureaucracy') accounted for 54% of all reported statements. Government financial parsimony was framed as responsible for the women's plight, with drug industry pricing never mentioned. Claimed benefits of Herceptin often conflated cancer non-recurrence and survival and favoured quantification rhetoric which emphasized percentage increases in improvement rather than the more modest increases in absolute survival. CONCLUSIONS: News frames invoking key tenets of the 'rule of rescue' dominated television discourse on Herceptin. Clinicians, patients, their families and patient advocacy groups invoking the rule of rescue can increase the likelihood of achieving their objective of gaining access to expensive healthcare such as pharmaceuticals. Rational, criteria-based public health policy will find it hard to resist the rule of rescue imperative.
BACKGROUND: In August 2006, the Australian government announced that Herceptin (Trastuzumab) would be added to the national Pharmaceutical Benefits Scheme (PBS) of government-subsidized drugs, for treatment with adjuvant chemotherapy of HER2 breast cancer. Following initial reticence, the health minister responded to a campaign by patients and patient advocacy groups by announcing PBS subsidization which lowered the cost of a weekly dose from A$1000 to A$30. The cost to the government would be A$470 million over three years for treatment of an estimated 2100 women annually. DESIGN: We analysed the news frames used in all direct and attributed statements (n=239) in television news coverage of the discourse preceding the Herceptin decision by the Australian government. SETTING: Five Sydney free-to-air channels between October 2005 and August 2006. MAIN OUTCOME MEASURES: News frames or themes. RESULTS: Of five news frames identified, one ('desperate, sick women in double jeopardy because of callous government/incompetent bureaucracy') accounted for 54% of all reported statements. Government financial parsimony was framed as responsible for the women's plight, with drug industry pricing never mentioned. Claimed benefits of Herceptin often conflated cancer non-recurrence and survival and favoured quantification rhetoric which emphasized percentage increases in improvement rather than the more modest increases in absolute survival. CONCLUSIONS: News frames invoking key tenets of the 'rule of rescue' dominated television discourse on Herceptin. Clinicians, patients, their families and patient advocacy groups invoking the rule of rescue can increase the likelihood of achieving their objective of gaining access to expensive healthcare such as pharmaceuticals. Rational, criteria-based public health policy will find it hard to resist the rule of rescue imperative.
Authors: Ian Smith; Marion Procter; Richard D Gelber; Sébastien Guillaume; Andrea Feyereislova; Mitch Dowsett; Aron Goldhirsch; Michael Untch; Gabriella Mariani; Jose Baselga; Manfred Kaufmann; David Cameron; Richard Bell; Jonas Bergh; Robert Coleman; Andrew Wardley; Nadia Harbeck; Roberto I Lopez; Peter Mallmann; Karen Gelmon; Nicholas Wilcken; Erik Wist; Pedro Sánchez Rovira; Martine J Piccart-Gebhart Journal: Lancet Date: 2007-01-06 Impact factor: 79.321
Authors: Martine J Piccart-Gebhart; Marion Procter; Brian Leyland-Jones; Aron Goldhirsch; Michael Untch; Ian Smith; Luca Gianni; Jose Baselga; Richard Bell; Christian Jackisch; David Cameron; Mitch Dowsett; Carlos H Barrios; Günther Steger; Chiun-Shen Huang; Michael Andersson; Moshe Inbar; Mikhail Lichinitser; István Láng; Ulrike Nitz; Hiroji Iwata; Christoph Thomssen; Caroline Lohrisch; Thomas M Suter; Josef Rüschoff; Tamás Suto; Victoria Greatorex; Carol Ward; Carolyn Straehle; Eleanor McFadden; M Stella Dolci; Richard D Gelber Journal: N Engl J Med Date: 2005-10-20 Impact factor: 91.245
Authors: Veronika J Wirtz; Hans V Hogerzeil; Andrew L Gray; Maryam Bigdeli; Cornelis P de Joncheere; Margaret A Ewen; Martha Gyansa-Lutterodt; Sun Jing; Vera L Luiza; Regina M Mbindyo; Helene Möller; Corrina Moucheraud; Bernard Pécoul; Lembit Rägo; Arash Rashidian; Dennis Ross-Degnan; Peter N Stephens; Yot Teerawattananon; Ellen F M 't Hoen; Anita K Wagner; Prashant Yadav; Michael R Reich Journal: Lancet Date: 2016-11-08 Impact factor: 79.321