How shall we set priorities among experimental treatment methods?
Norheim, O.F.; Ekeberg, O.; Evensen, S.A.; Halvorsen, M.; Kvernebo, K.
Nordisk Medicin 113(1): 17-18; 23-24
1998
ISSN/ISBN: 0029-1420 PMID: 9465703 Document Number: 491158
There is an increasing demand from patients to have access to new and promising treatment for severe diseases. Norway has recently started ordinary public funding of large-scale clinical investigation of treatment effect and safety for new treatment modalities. The government has thus established a new principle for funding a sub-category of clinical research: investigational medicine. How should we prioritize between promising clinical protocols when resources are scarce? The article examines criteria for priority setting in investigational medicine: quality of evidence; magnitude of expected benefit from treatment; balance between risks and benefits; quality of the research protocol; cost; and size of patient population. These criteria are applied on a controversial clinical examples, high-dose chemotherapy with hematopoietic stem cell support for metastatic breast cancer.