文章基本信息

标题：Expensive lifesaving treatments: allocating resources and maximizing access
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作者：Rachel Nissanholtz-Gannot ; David Chinitz
期刊名称：Israel Journal of Health Policy Research
印刷版ISSN：2045-4015
电子版ISSN：2045-4015
出版年度：2018
卷号：7
期号：1
页码：3
DOI：10.1186/s13584-017-0195-7
语种：English
出版社：BioMed Central
摘要：Avisar et al. present an exemplary model for outreach aimed at ensuring that a maximum of patients eligible for expensive Hepatitis C (HPC) drugs receive treatment. We enlarge the picture to put their model in the political, economic and regulatory framework for financing and providing these drugs in Israel and a number of other countries. We then return to delivery system level and consider issues such as cost of outreach, the need for health care coordinators and dealing with Hepatitis C patients not yet entitled to receive the drugs under national health coverage determinations. Regarding national coverage decisions, we find that countries such as Australia, New Zealand, the United Kingdom and Israel all extended coverage for Hepatitis C drugs, given the clear high effectiveness of the latter. However, to limit budget impact, all these countries target coverage to patients based on disease genotype and stage. The model presented by Avisar et al., while impressive, leaves some items to address. These include: whether all resources allocated to HPC drugs are actually used for this purpose, the roles of outreach to HPC patients who do not meet the guidelines for treatment, and a comparison of the effectiveness of the model vs. a variety of costs associated with it.