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Pace J, Ghinea N, Pearson SA, Kerridge I, Lipworth W. Consumer perspectives of accelerated access to medicines: a qualitative study. J Health Organ Manag 2021; ahead-of-print. [PMID: 34128376 DOI: 10.1108/jhom-08-2020-0344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE In this study, the authors aimed to explore consumer perspectives on accelerated access to medicines. The authors were particularly interested in how they balance competing considerations of safety, efficacy, equity and access; whether and how their views change when there are different levels of uncertainty surrounding the safety and efficacy of new medicines; and the procedures that they think should be used to make decisions about accelerated access to new medicines. DESIGN/METHODOLOGY/APPROACH This was an exploratory qualitative study. Thirteen semi-structured interviews with patient advocates and two focus groups with patients were conducted and analysed thematically. Interviews and focus groups were audio recorded and transcribed verbatim. Data were analysed through inductive thematic analysis. FINDINGS Participants outlined a range of justifications for accelerated access, including addressing unmet medical needs and encouraging further research and development. However, they were also cognisant of the potential risks and viewed ongoing data collection, disinvestment and market withdrawal as ways to address these. They also emphasised the importance of transparent decisions being made by people with relevant expertise, based on a thorough consideration of scientific evidence and stakeholder perspectives. ORIGINALITY/VALUE This is the first study to comprehensively explore Australian consumers' views of accelerated access to medicines. The results suggest that consumers want timely access to new medicines, but not at the expense of safety, efficacy, equity and sustainability. While accelerated access programs are likely to be welcomed by consumers, they must be fully informed of their conditions and limitations, and robust post-market data surveillance must be implemented and enforced to protect the interests of both individual patients and the broader community.
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Affiliation(s)
- Jessica Pace
- Sydney Health Ethics, The University of Sydney, Sydney, Australia
| | - Narcyz Ghinea
- Sydney Health Ethics, University of Sydney, Sydney, Australia
| | - Sallie-Anne Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Ian Kerridge
- Sydney Health Ethics, University of Sydney, Sydney, Australia
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Ghinea N, Critchley C, Morrell B, Kerridge I, Campbell T, Day R, Gazarian M, Isaacs D, Liauw W, Olver I, Pace J, Pearson S, Salkeld G, Lipworth W. A survey of Australian public attitudes towards funding of high cost cancer medicines. Health Policy 2020; 125:327-334. [PMID: 33402264 DOI: 10.1016/j.healthpol.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In the past decade many novel, and in some cases transformative, cancer medicines have entered the market. Their prices and the amount spent on them by governments have increased rapidly, bringing to the forefront trade-offs that must be made. In this paper we explore the Australian public's attitude towards the funding of high cost cancer medicines (HCCM) to inform reimbursement and health technology assessment (HTA) policy. METHODS A survey consisting of 49 questions about the funding of HCCMs was developed by the investigators. Recruitment was conducted via Qualtrics. 1039 Australian adults completed the survey. RESULTS The Australian public overwhelmingly supports funding of HCCMs (95.5 %) to enhance equity of access (97.8 %), and to respond to patients' needs (98 %). When respondents were challenged to balance equity versus access in different contexts inconsistencies emerged. Different demographic factors were important in predicting support for various strategies. CONCLUSION Our results suggest that the Australian public strongly supports government funding of HCCMs and values both equity and access. Equally, however, the public is uncertain about how equity and access are to be balanced and achieved, and such ambivalence needs to be both further explored and accommodated in policy processes. Our results may be used by policymakers in Australia, and countries with similar systems and values, to further develop policies and processes for funding HCCMs.
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Affiliation(s)
- Narcyz Ghinea
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia.
| | - Christine Critchley
- Swinburne University of Technology, School of Health Sciences, Department of Psychology, VIC 3122, Australia
| | - Bronwen Morrell
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
| | - Ian Kerridge
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia; Haematology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Terry Campbell
- UNSW Sydney, Faculty of Medicine, NSW 2052, Australia; St Vincent's Hospital Sydney, NSW 2010, Australia
| | - Richard Day
- UNSW Sydney, St Vincent's Clinical School, NSW 2010, Australia
| | | | - David Isaacs
- The University of Sydney, Faculty of Medicine and Health, NSW 2050, Australia; The Children's Hospital at Westmead, NSW 2145, Australia
| | - Winston Liauw
- UNSW Sydney, St George and Sutherland Clinical School, NSW 2217, Australia
| | - Ian Olver
- The University of Adelaide, Faculty of Health and Medical Sciences, School of Psychology, Australia
| | - Jessica Pace
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
| | - Sallie Pearson
- UNSW Sydney, Centre for Big Data Research in Health, NSW 2052, Australia; The University of Sydney, Faculty of Medicine and Health, Menzies Centre for Health Policy, NSW 2006, Australia
| | - Glenn Salkeld
- The University of Wollongong, Faculty of Social Sciences, NSW 2522, Australia
| | - Wendy Lipworth
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
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Ghinea N, Lipworth W, Kerridge I. Lead Essay: Money, Equity and Access to Medicines. JOURNAL OF BIOETHICAL INQUIRY 2020; 17:25-27. [PMID: 32124176 DOI: 10.1007/s11673-020-09966-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Narcyz Ghinea
- Sydney Health Ethics, University of Sydney, Level 1, Medical Foundation Building K25, Sydney, NSW, 2006, Australia.
| | - Wendy Lipworth
- Sydney Health Ethics, University of Sydney, Level 1, Medical Foundation Building K25, Sydney, NSW, 2006, Australia
| | - Ian Kerridge
- Sydney Health Ethics, University of Sydney, Level 1, Medical Foundation Building K25, Sydney, NSW, 2006, Australia
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