Dickerson Justin B
Department of Health Policy & Management; School of Rural Public Health; Texas A&M Health Science Center; College Station, TX, USA.
Hum Vaccin. 2011 Apr;7(4):477-80. doi: 10.4161/hv.7.4.14189. Epub 2011 Apr 1.
Sipuleucel-T (known by the trade name, "Provenge") is the first prostate cancer vaccine approved by the Food and Drug Administration (FDA), and represents a new type of cancer therapy termed, Autologous Cellular Immunotherapy (ACT). This therapy has been described as a revolution in technology by clinicians and researchers alike. However, policy-makers and health economists question the efficacy of such treatment given its costs, while mainstream media often bemoan Provenge as yet another example of a healthcare system gone awry. This paper examines the debate for and against Provenge, and discusses why Medicare adoption of payment protocols for the vaccine may violate the egalitarian and feminist principles of distributive justice theory. The paper also acknowledges the larger context of the Provenge debate within the bioethical community; that is, how much should society be willing to invest to prevent death? The paper concludes by arguing for a more thorough ethical review of such new technologies by policy-makers prior to the adoption of funding protocols.
西普尼克- T(商品名为“普列威”)是美国食品药品监督管理局(FDA)批准的首款前列腺癌疫苗,代表了一种名为自体细胞免疫疗法(ACT)的新型癌症治疗方法。临床医生和研究人员都将这种疗法描述为技术上的一场革命。然而,政策制定者和健康经济学家鉴于其成本对这种治疗方法的疗效提出质疑,而主流媒体经常哀叹普列威是医疗保健系统出问题的又一个例子。本文审视了支持和反对普列威的争论,并讨论了医疗保险采用该疫苗支付方案为何可能违反分配正义理论的平等主义和女权主义原则。本文还承认了生物伦理学界关于普列威争论的更大背景;也就是说,社会应该愿意投入多少来预防死亡?本文最后主张政策制定者在采用资助方案之前,对这类新技术进行更全面的伦理审查。