Halfway Technologies, Quality of Life, and Affordable Public Health Policy: Biotechnology Drug Developments for Multiple Sclerosis

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The cost control problems associated with funding half-way medical technologies in national health insurance systems are considered, in the context of analyzing the effectiveness, efficiency and equity implications of publicly funding the new biotechnology drugs for treating multiple sclerosis. It is suggested that, while lip service is played to all three types of assessment for formulating public policy, in practice decision-making is based on the effectiveness and efficiency evidence only. The consequence is an inability to formulate resource allocation decisions where distributional health effects among patients are involved. The development of equity norms would not only generate more consistency and justification to distributional decisions, but also increase the ability of policy makers to make distributional choices explicitly in contexts where the implications of doing so implicitly are spiralling health care costs. For the purpose of increased cost control, almost any set of explicit equity norms would do, which does not mean to say that all equity norms are equally appealing, either philosophically or electorally. The development of explicit and socially acceptable equity norms is a high priority goal, even though their development requires more explicit judgements about what constitutes fair collective funding arrangements than either analysts or society have been want to make.