Dr Rob Glynne-Jones and Prof. Karol Sikora debate the issues of top-up payments with both concluding that the NHS must make substantial changes in administration and management structure.
The NHS was in need of reform to meet patient behavioural changes, and the introduction of top-up payments puts more pressure on a system based on outdated requirements. Extra resources and management will be needed from the outset in order to effectively manage the payment transactions and keep accurate records of patient care and payment.
Dr Glynne-Jones highlights, “The cost of the drug is not the only cost to the NHS; patients who purchase the drug and stay in the NHS reduce the resources for all remaining patients.”
Dr Glynne-Jones continues, “A co-payment system poses major risks to society: co-payment would require an administrative system to authorise, and police it, which will not be cost neutral to the NHS. In some circumstances the NHS may eventually be obliged to pick up the costs anyway, when a patient runs out of money, since the European Court of Human Rights may continue a treatment that is clearly keeping them alive.”
Patients have become very sophisticated consumers, seeking knowledge and answers on the internet, making their own treatment demands and increasingly eager to understand the diagnosis. They will also want to understand their position if making a top-up decision including any potential after-care payments. Clear guidelines for implementation are needed for now both staff and patients. As Prof Sikora says, “A suitable infrastructure for the ethical delivery of top-up services is urgently required. This could drive choice and competition throughout cancer care leading to real reform and value, whoever pays.”
Other cost considerations and resource issues include: the administration of the drug, – infusion time, complexity and cost of accompanying symptom control medication, dealing with side effects, extra doctor, nursing and pharmacist time.
Prof. Sikora suggests that “a fixed total tariff including all the costs above is calculated in advance of drug delivery and given as an option to the patient in writing. A supplement of 30% to the actual drug cost is likely for most intravenous and 15% for oral administration.”
Sarah Hayton | alfa
Cholesterol-lowering drugs may fight infectious disease
22.08.2017 | Duke University
Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
22.08.2017 | Health and Medicine
22.08.2017 | Materials Sciences
22.08.2017 | Life Sciences