Literature DB >> 23974470

Can the NICE "end-of-life premium" be given a coherent ethical justification?

Richard Cookson1.   

Abstract

In 2009 the UK National Institute for Health and Clinical Excellence (NICE) announced that its health technology appraisal committees would henceforth give special additional weight to health gains from life-extending end-of-life treatments. This was a response to mounting concern from NICE's stakeholders that effective new drugs for end-stage cancer often fail NICE's standard test of cost effectiveness. This change of policy may be justifiable on procedural grounds as the result of a democratic political process responding to stakeholder concerns. However, according to the "accountability for reasonableness" framework proposed by the philosopher Norman Daniels and endorsed by NICE, there also needs to be transparency about the substantive ethical grounds for public health care resource allocation decisions. In that spirit, I analyze eleven potentially relevant justifications for the NICE "end-of-life premium," drawn from the economics and philosophy literature: (1) rule of rescue, (2) fair chances, (3) ex post willingness to pay, (4) caring externality, (5) financial protection, (6) symbolic value, (7) diminishing marginal value of future life years, (8) concentration of benefits, (9) dread, (10) time to set your affairs in order, and (11) severity of illness. I conclude that none of them yields a coherent ethical justification for the NICE end-of-life premium.

Entities:  

Mesh:

Year:  2013        PMID: 23974470     DOI: 10.1215/03616878-2373166

Source DB:  PubMed          Journal:  J Health Polit Policy Law        ISSN: 0361-6878            Impact factor:   2.265


  7 in total

1.  Application of a policy framework for the public funding of drugs for rare diseases.

Authors:  Eric Winquist; Doug Coyle; Joe T R Clarke; Gerald A Evans; Christine Seager; Winnie Chan; Janet Martin
Journal:  J Gen Intern Med       Date:  2014-08       Impact factor: 5.128

2.  The Cost Effectiveness of Docetaxel and Active Symptom Control versus Active Symptom Control Alone for Refractory Oesophagogastric Adenocarcinoma: Economic Analysis of the COUGAR-02 Trial.

Authors:  David M Meads; Andrea Marshall; Claire T Hulme; Janet A Dunn; Hugo E R Ford
Journal:  Pharmacoeconomics       Date:  2016-01       Impact factor: 4.981

3.  Cancer Drugs Fund 2.0: A Missed Opportunity?

Authors:  Christopher McCabe; Ash Paul; Greg Fell; Mike Paulden
Journal:  Pharmacoeconomics       Date:  2016-07       Impact factor: 4.981

4.  Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

Authors:  Richard Cookson; Andrew J Mirelman; Susan Griffin; Miqdad Asaria; Bryony Dawkins; Ole Frithjof Norheim; Stéphane Verguet; Anthony J Culyer
Journal:  Value Health       Date:  2017-02       Impact factor: 5.725

5.  Oncologists' and family physicians' views on value for money of cancer and congestive heart failure care.

Authors:  Dan Greenberg; Ariel Hammerman; Shlomo Vinker; Adi Shani; Yuval Yermiahu; Peter J Neumann
Journal:  Isr J Health Policy Res       Date:  2013-11-18

6.  Improving Patient Access to New Drugs in South Korea: Evaluation of the National Drug Formulary System.

Authors:  Seung-Lai Yoo; Dae-Jung Kim; Seung-Mi Lee; Won-Gu Kang; Sang-Yoon Kim; Jong Hyuk Lee; Dong-Churl Suh
Journal:  Int J Environ Res Public Health       Date:  2019-01-21       Impact factor: 3.390

7.  Does NICE apply the rule of rescue in its approach to highly specialised technologies?

Authors:  Victoria Charlton
Journal:  J Med Ethics       Date:  2021-03-08       Impact factor: 2.903

  7 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.