Last month Acronym Required wrote about the conundrum of sophisticated technology treatments that are too expensive for patients who need them. Here are a few recent articles that discuss related issues or aspects of that article.
--Plos Medicine published "Rationing Antiretroviral Therapy for HIV/AIDS in Africa: Choices and Consequences", in November. The premise of the article is that public discourse about rationing medicine and transparency in policy decisions will provide the most "socially desirable outcome". The article discusses rationing methods for AIDS medications that are currently used in Africa. An intentional rationing program exists in the treatment of infants with drugs that prevent mother to child transmission of the virus, a decision that allocates resources to save infants from becoming AIDS inflicted orphans. Unintentional rationing occurs when people are privileged to receive drugs, or when queueing favors those who have time to stand in line, the unemployed for instance.
--The Wall Street Journal (subscription) published an article, "Through Charities, Drug Makers Help People - and Themselves", (Dec. 1) that followed the stories of several patients who were aided by non-profit organizations funded by drug companies to provide co-pays to patients who have insurance coverage but can't afford the co-payment.
"...people with insurance are increasingly finding it difficult to afford these drugs. In response, drug companies are giving money to charities that are specifically set up to help patients pay such costs...Under this support system, drug-company money keeps patients insured -- and keeps insurers paying for the high-priced medicine."
Drug companies can often tax deduct their donations. Patients recieve medications but the benefits are sometimes short-lived since charities can arbitrarily limit a patient's participation.
--The University of Toronto Center for Bioethics published a report that urges open and ethical decisions ahead of a flu pandemic. "A key lesson from the SARS outbreak is that fairness becomes more important during a time of crisis and confusion. And the time to consider these questions and processes in relation to a threatened major pandemic is now.", said Peter Singer, M.D.. The report deals with issues around the duty of health workers, possible restrictions on travel and liberty and resource allocations in the time of an epidemic.
