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Value congruence in health care priority setting: social values, institutions and decisions in three countries

Published online by Cambridge University Press:  01 December 2014

Claudia Landwehr  and
Dorothea Klinnert
Claudia Landwehr*
Affiliation:
Department of Political Science, Johannes Gutenberg-University Mainz, Mainz, Germany
Dorothea Klinnert
Affiliation:
Department of Political Science, Johannes Gutenberg-University Mainz, Mainz, Germany
*
*Correspondence to: Prof. Claudia Landwehr, Department of Political Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany. Email: [email protected]
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Abstract

Most developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at large, will ultimately depend not only on considerations of procedural fairness, but also on the congruence between a society’s values and its institutions. We study social values, institutions and decisions in three countries (France, Germany and the United Kingdom) in order to assess such congruence and formulate expectations on its effects.

Type
Articles
Information
Health Economics, Policy and Law , Volume 10 , Issue 2 , April 2015 , pp. 113 - 132
Copyright
© Cambridge University Press 2014 

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References

References

Bayer, K. (2007), Argument und Argumentation: Logische Grundlagen der Argumentationsanalyse, Gottingen: Vandenhoeck & Ruprecht.Google Scholar
Biron, L., Rumbold, B. and Faden, R. (2012), ‘‘Social value judgments in healthcare: a philosophical critique’’, Journal of Health Organization and Management, 26(3): 317–330.CrossRefGoogle ScholarPubMed
Böhm, K., Landwehr, C. and Steiner, N. (2014), ‘What explains ‘‘generosity’’ in the public financing of high-tech drugs?’, Journal of European Social Policy, 24(1): 39–55.CrossRefGoogle Scholar
Clarke, S. and Weale, A. (2012), ‘Social values in health priority setting: a conceptual framework’, Journal of Health Organization and Management, 26(3): 293–316.CrossRefGoogle Scholar
Culyer, A. J. and Wagstaff, A. (1993), ‘Equity and equality in health and health care’, Journal of Health Economics, 12: 431–457.CrossRefGoogle ScholarPubMed
Daniels, N. (2008), Just Health. Meeting Health Needs Fairly, Cambridge: Cambridge University Press.Google Scholar
Daniels, N. and Sabin, J. E. (1997), ‘Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insures’, Philosophy and Public Affairs, 26(4): 303–350.CrossRefGoogle Scholar
DoH (2013), The NHS Constitution for England, London: Department of Health.Google Scholar
HAS (2011), Rapport d’activité 2011 de la Commission de la Transparence, Saint-Denis La Plaine Cedex: Haute Autorité de Santé.Google Scholar
Holm, S. (2000), ‘Developments in the Nordic countries – goodbye to the simple solutions’, in A. Coulter and C. Ham (eds), The Global Challenge of Health Care Rationing, Buckingham, Philadelphia: Open University Press, 29–37.Google Scholar
ISSP (2011), International Social Survey Programme: Health – ISSP 2011. GESIS Data Archive, Cologne.Google Scholar
Landwehr, C. and Böhm, K. (2011), ‘Delegation and institutional design in health care rationing’, Governance, 24(4): 665–688.CrossRefGoogle Scholar
Liesching, F., Meyer, T. and Raspe, H. (2012), ‘The national public discourse on priority setting in health care in German print media’, Zeitschrfit für Evidenz, Fortbildung und Qualität im Gesundheitswesen (ZEFQ), 106(6): 396.Google ScholarPubMed
Littlejohns, P., Sharma, T. and Jeong, K. (2012), ‘Social values and health priority setting in England: “values” based decision making’, Journal of Health Organization and Management, 26(3): 363–371.CrossRefGoogle ScholarPubMed
Littlejohns, P., Yeung, K., Clark, S. and Weale, A. (2012), ‘A proposal for a new social values research program and policy network’, Journal of Health Organization and Management, 26(3): 407–421.CrossRefGoogle ScholarPubMed
Miller, D. (1999), Principles of Social Justice, Cambridge, MA: Harvard University Press.Google Scholar
Moe, T. M. (2005), ‘Power and political institutions’, Perspectives on Politics, 3(2): 215–233.CrossRefGoogle Scholar
Nord, E. (1999), Cost Value Analysis in Health Care: Making Sense out of QALYs, Cambridge: Cambridge University Press.CrossRefGoogle Scholar
NHS (2005), Directions and consolidating directions to the National Institute for Health and Clinical Excellence 2005, London: NHS.Google Scholar
NICE (2008), Social Value Judgements. Principles for the Development of NICE Guidance, London: National Institute for Health and Clinical Excellence.Google Scholar
OECD (2014), Health Statistics, online database.Google Scholar
Roemer, J. E. (1995), ‘Equality and responsibility’, Boston Review, 20(2): 3–7.Google Scholar
Schmidt, V. A. (2013), ‘Democracy and legitimacy in the european union revisited: input, output and ‘‘throughput’’’, Political Studies, 61(1): 2–22.CrossRefGoogle Scholar
Sen, A. (2002), ‘Why health equity?’, Health Economics, 11: 659–666.CrossRefGoogle ScholarPubMed
Wikler, D. (2004), ‘Personal and social responsibility for health’, in S. Anand, F. Peter, A. Sen (eds), Public Health, Equity and Ethics, Oxford: Oxford University Press, 107–133.Google Scholar
Zimmermann, C. (2012), ‘Der Gemeinsame Bundesausschuss: Normsetzung durch Richtlinien sowie Integration neuer Untersuchungs-und Behandlungsmethoden in den Leistungskatalog der GKV’, Berlin/Heidelberg: Springer Verlag.CrossRefGoogle Scholar

Sources

France: Haute Autorité de Santé

CT-4154, Champix (Varenicline), 23.08.2007.Google Scholar
CT-5270, Torisel (Temsirolimus), 06.02.2008.Google Scholar
CT-5952, Ebixa (Memantine), 26.11.2008.Google Scholar
CT-6739, Forsteo (Teriparatide), 22.07.2009.Google Scholar
CT-9411, Herceptin (Trastuzumab, cancer gastrique métastatique), 16.02.2011.Google Scholar
CT-11948, Tysabri (Natalizumab), 29.02.2012.Google Scholar

Germany: Federal Joint Committee

FJC 17.09.2009: Tragende Gründe zum Beschluss des Gemeinsamen Bundesausschusses über die Einleitung eines Stellungnahmeverfahrens zur Änderung der Arzneimittel-Richtlinie (AM-RL): Anlage XI – Besondere Arzneimittel, Besondere Arzneimittel nach §73d SGB V bei der Behandlung des metastasierten und/oder fortgeschrittenen Nierenzellkarzinoms: Bevacizumab, Sorafenib, Sunitinib, Temsirolimus.Google Scholar
FJC 10.08.2010: Tragende Gründe zum Beschluss des Gemeinsamen Bundesausschusses über die Einleitung eines Stellungnahmeverfahrens zur Änderung der Arzneimittel-Richtlinie (AM-RL): Anlage III – Übersicht der Verordnungseinschränkungen und –ausschlüsse (Memantine).Google Scholar
FCJ 18.08.2011: Tragende Gründe zum Beschluss des Gemeinsamen Bundesausschusses über eine Nichtänderung der Arzneimittel-Richtlinie (AM-RL): Anlage III – Übersicht der Verordnungseinschränkungen und –ausschlüsse (Memantine).Google Scholar
FCJ 16.10.2008: Tragende Gründe zum Beschluss des Gemeinsamen Bundesausschusses über eine Änderung der Arzneimittel-Richtlinie in Anlage 4: Therapiehinweis zu Natalizumab.Google Scholar
FCJ 09.04.2009: Bekanntmachung eines Beschlusses des Gemeinsamen Bundesausschusses über eine Änderung der Arzneimittel-Richtlinie in Anlage 4: Therapiehinweis zu Natalizumab.Google Scholar

United Kingdom: National Institute for Health and Care Excellence

NICE-TA 123, Varenicline for smoking cessation, 25.07.2007.Google Scholar
NICE-TA 127, Natalizumab for the treatment of adults with highly active relapsing–remitting multiple sclerosis.Google Scholar
NICE-TA 161, Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women.Google Scholar
NICE-TA 178, Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma, 26.08.2009.Google Scholar
NICE-TA 208, Trastuzumab for the treatment of HER2-positive metastatic gastric cancer, 24.11.2010.Google Scholar
NICE-TA 217, Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease, 23.11.2011.Google Scholar