Cost-effectiveness analysis in a setting of budget constraints: is it equitable?

Article Abstract:

Equal access to health care services may outweigh financial and other priorities in the context of cost-effective distribution of medical procedures. Although cost-effectiveness may maximize available resources, selecting the beneficiaries of these scarce services would result in perceived inequalities and moral dilemma. Researchers surveyed the preferences of 568 prospective jurors from the general population, 74 bioethicists, and 73 experts in medical decision-making with respect to two diagnostic tests for colon cancer. A theoretical dilemma was presented, whereby one test could be offered to all people or another more expensive test could be available to 50% of all people. The second test would save 1,100 lives, 100 lives more than the first test. Basing their preference on the principle of equality, 56% of the jurors and 53% of the ethicists recommended testing everyone with the less cost-effective test. Only 41% of the experts in medical decision-making advocated this approach.

Usage, Economic aspects, Surveys, Ethical aspects, Medical care, Cost of, Health care costs, Bioethics, Diagnostic services, Patient advocacy

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Direct sale of sildenafil (Viagra) to consumers over the Internet

Article Abstract:

Many consumers can buy Viagra on the Internet without going through a doctor or pharmacist. This means they will be buying the drug without knowing about its proper use or potential side effects. Researchers identified 77 Web sites that sold Viagra directly to consumers. Although half the sites required consumers to fill out an online medical evaluation, only half of these sites said that a doctor would review the evaluation. Forty percent of the sites did not ask for any information. Many sites also did not provide any information about possible side effects of Viagra or whether it interacted with other drugs.

Internet, Marketing, Information services, Viagra (Medication), Sildenafil

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Rationing by any other name

Article Abstract:

Many physicians engage in rationing health care resources even though they might not use the term to describe their actions. This often occurs in the context of reducing health care costs. One way this is done is to use the accepted standard of care even though there may be more effective but expensive alternates. Managed care plans force patients to see certain specialists even though another physician may be more suitable. Some physicians will try the best treatment only after other cheaper treatments have failed. All of these scenarios are used to control costs.

Analysis, Health care rationing

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