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Ethics in Drug Developmental Processes – Societal Perspectives

Ethics in Drug Developmental Processes – Societal Perspectives. Joint Medicines Policy Conference 2011 Jennifer Doggett. Dorian Gray pill Biologically-targeted Stops ageing No side effects $100k per year. Ref: Prof Greg Mankiw NY Times 2009. Policy response – open market. Cost Equity.

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Ethics in Drug Developmental Processes – Societal Perspectives

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  1. Ethics in Drug Developmental Processes – Societal Perspectives Joint Medicines Policy Conference 2011 Jennifer Doggett

  2. Dorian Gray pill • Biologically-targeted • Stops ageing • No side effects • $100k per year Ref: Prof Greg Mankiw NY Times 2009

  3. Policy response – open market Cost Equity

  4. Policy response – subsidise for all Cost Equity

  5. Policy response – partial subsidy • Old or young? • Sick or well? • Disadvantaged? • Everyone the same? Cost? Equity?

  6. Policy response – total ban Equity Cost

  7. How to decide? • Values and ethics • Trade-offs – opportunity costs • No empirically ‘right’ answer • ‘Right’ answer is the one which best reflects community values/preferences

  8. Who decides?

  9. Evidence of the problem • “Jurors stated that the current distribution of health care does not adequately reflect the value they attached to equity” • Ref: Citizens Jury on health priorities 2010—Report by ACT Health Council • Consumer feedback • Adverse events • Reporting mechanisms • Lack of transparency • Post-market surveillance • Poor communication • Lags behind other areas • Solutions ignored

  10. The 7 Deadly Sins of ‘Healthspeak’ • Sustainability • Priorities • Resource constraints • Risk issues • Data gaps • Privacy • Complexity/technical barriers

  11. Set-top box VS New Arthritis medicine

  12. Trends in health care 1960s Choice Individualism Targeting Diversity Interactive Linkages 1980s 2010s

  13. Values and principles • Values and ethics issues • No underlying principles • Missed opportunity - NHHRC • Community values • Citizen focus – engage minorities/disadvantaged • Ongoing process

  14. Key questions • How much do we spend on health? • Where should we allocate resources? • What proportion of costs should be shared?

  15. Other processes:Consumer Reps • Progress but still gaps • Isolated • Increased support • Networking • Role of peaks crucial • Communication • Research base

  16. Consumer input: Future trends • Pro-active • Dynamic • Interactive • New technologies • Multiple sources/processes • Personalised • Real-time • Mobile

  17. Future directions • Citizens’ Council - NICE • Crowdsourcing • Deliberative democracy • Social media • Microparticipation • Prediction markets • Wikis • Market data www.expertlabs.org http://cdd.stanford.edu www.nice.org.uk www.activedemocracy.net Dr Kathy Stiller AHR 2008 Vol 32 No 2 It’s not the evidence, it’s the way that you use it.

  18. Conclusion • No crystal ball • Principles and values • Robust processes • Cultures • Inertia • Point the thumb

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