Spandonaro Federico
Recenti Prog Med. 2014 Jun;105(6):227-32. doi: 10.1701/1543.16849.
The availability of new drugs potentially able to drastically reduce the burden of very common infectious diseases like hepatitis C requires the national health services to take a different decision-making process. On the one hand, there is an evident financial issue; on the other hand, low budgets may undermine a system that provides universal access to healthcare. It is unrealistic to expect retrieving the financial resources needed from negotiating prices with pharmaceutical companies, resource reallocation or a reduction in economic waste. The national health systems need a new priority setting and a National fund for healthcare innovation should be built. Novel drugs should be evaluated balancing availability and opportunity, forcing to rethink the decision-making processes. Macro- (re-prioritization of interventions) and micro-policies (the introduction of financial aspects in the process of pricing) are needed, trying to combine welfare and industrial policies.
新型药物的出现有可能大幅减轻诸如丙型肝炎等非常常见的传染病的负担，这就要求国家卫生服务部门采取不同的决策过程。一方面，存在明显的财务问题；另一方面，低预算可能会破坏一个提供全民医疗保健服务的体系。期望通过与制药公司谈判价格、重新分配资源或减少经济浪费来获取所需的财政资源是不现实的。国家卫生系统需要重新确定优先事项，应设立一个国家医疗保健创新基金。对于新型药物，应在可用性和机会之间进行权衡评估，这迫使人们重新思考决策过程。需要宏观政策（重新确定干预措施的优先顺序）和微观政策（在定价过程中引入财务因素），试图将福利政策和产业政策结合起来。
