Ferguson J S, Summerhayes M, Masters S, Schey S, Smith I E
Lambeth, Southwark and Lewisham Health Authority, 1 Lower Marsh, London, SE1 7NT.
Br J Cancer. 2000 Nov;83(10):1268-73. doi: 10.1054/bjoc.2000.1406.
The allocation of funding for new anticancer treatments within the UK has not kept pace with demand. Clinicians find themselves restricted in the use of licensed drugs which they feel are in the best interests of individual patients. Against this, health authorities have a duty to ensure that scarce resources are used equitably to meet the needs of the local population as a whole. Differential levels of funding for new treatments across the country have led to concerns about rationing by postcode. This paper outlines an approach to the prioritization of new treatment for advanced cancer developed jointly by clinicians and health authorities in South London. The approach involves evidence reviews and consensus meetings. Existing and new treatments are rated on a four-point 'relative effectiveness scale', which takes account of the impact of the treatment on quality of life and on survival. The strength of evidence supporting each effectiveness rating is also classified. Health Authorities have used these ratings to determine overall funding levels, while leaving decisions on individual patients to the relevant Trusts.
在英国，用于新型抗癌治疗的资金分配未能跟上需求。临床医生发现，他们在使用自认为最符合个别患者利益的已获许可药物时受到限制。与此相反，卫生当局有责任确保稀缺资源得到公平利用，以满足当地全体居民的需求。全国各地新型治疗的资金水平存在差异，这引发了对按邮编配给的担忧。本文概述了伦敦南部的临床医生和卫生当局联合制定的一种对晚期癌症新型治疗进行优先排序的方法。该方法包括证据审查和共识会议。现有治疗和新型治疗根据一个四点“相对有效性量表”进行评级，该量表考虑了治疗对生活质量和生存的影响。支持每个有效性评级的证据强度也进行了分类。卫生当局利用这些评级来确定总体资金水平，而将关于个别患者的决策留给相关信托机构。
