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在丹麦医疗保健系统中昂贵的生物疗法的公正优先排序原则。

Principles for Just Prioritization of Expensive Biological Therapies in the Danish Healthcare System.

机构信息

Danish College of Pharmacy Technicians, Hillerød, Denmark.

Department of Biomedicine, Aarhus University, Aarhus, Denmark.

出版信息

J Bioeth Inq. 2023 Sep;20(3):523-542. doi: 10.1007/s11673-023-10283-2. Epub 2023 Sep 21.

Abstract

The Danish healthcare system must meet the need for easy and equal access to healthcare for every citizen. However, investigations have shown unfair prioritization of cancer patients and unfair prioritization of resources for expensive medicines over care. What is needed are principles for proper prioritization. This article investigates whether American ethicists Tom Beauchamp and James Childress's principle of justice may be helpful as a conceptual framework for reflections on prioritization of expensive biological therapies in the Danish healthcare system. We present an empirical study exploring the principles for prioritizing new expensive biological therapies. This study includes qualitative interviews with key Danish stakeholders experienced in antibody therapy and prioritizing resources for expensive medicines. Beauchamp and Childress's model only covers government-funded primary and acute healthcare. Based on the interviews, this study indicates that to be helpful in a Danish context this model should include equal access for citizens to government-funded primary and acute healthcare, costly medicine, and other scarce treatments. We conclude that slightly modified, Beauchamp and Childress's principle of justice might be useful as a conceptual framework for reflections on the prioritization of expensive biological therapies in the Danish healthcare system.

摘要

丹麦的医疗保健系统必须满足每个公民都能轻松和平等地获得医疗保健的需求。然而,调查显示,癌症患者存在不公平的优先排序,昂贵药物的资源分配也存在不公平,而对医疗的关注则不足。现在需要的是正确排序的原则。本文探讨了美国伦理学家汤姆·比彻姆和詹姆斯·钱德勒的公正原则是否可以作为丹麦医疗保健系统中昂贵生物疗法排序的概念框架。我们介绍了一项实证研究,探讨了为昂贵的生物疗法排序的原则。这项研究包括对在抗体治疗和昂贵药物资源分配方面有经验的丹麦主要利益相关者的定性访谈。比彻姆和钱德勒的模型仅涵盖政府资助的初级和急性保健。根据访谈,这项研究表明,要在丹麦语境下具有帮助,该模型应包括公民平等获得政府资助的初级和急性保健、昂贵药物和其他稀缺治疗的机会。我们的结论是,经过略微修改,比彻姆和钱德勒的公正原则可能会成为丹麦医疗保健系统中昂贵生物疗法排序的概念框架。

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