8 Equity in Healthcare

Question 1

What problem is presented by standard cost-effectiveness methods?

Answer 1

they ignore health equity

Question 2

What is horizontal equity?

Answer 2

individuals with the same need for healthcare have the same use for healthcare

Question 3

What is vertical equity?

Answer 3

individuals with different levels of ill health have different levels of use

Question 4

In HIV treatment for example, how might CEA and Equity disagree?

Answer 4

CEA - universal screen and early treatment

Equity - prioritise severely ill

Question 5

When should we consider equity impacts?

Answer 5

if something is not cost effective (like for rare diseases or EoL care)

population wide public health interventions

Question 6

What are the exceptions to CEA according to NICE?

Answer 6

EoL care
Ultra-Orphan drugs (HST)
Cancer Drugs Fund

Question 7

What problems are associated with the CDF?

Answer 7

cancer drugs fund

issues with ballooning budgets and quick fixes
some have questioned the fairness of the NHS prioritising cancer over other diseases

Question 8

what exception is made for End of Life care?

Answer 8

£50 000 may be granted for a treatment extending life by 3 months if someone has less than 24 months to liive

Question 9

What did Sakellarious and Rotarou find?

Answer 9

severe disability associated with higher odds of umet needs (worse in women)

due to barriers (transport, prescription costs, long waiting lists)

similar findings were observed in the UK