Patients' views of priority setting for new medicines. A qualitative study of patients with rheumatoid arthritis.
OBJECTIVE
To identify rheumatoid arthritis patients' perceptions about what should govern priority setting for the new class of high-cost anti-rheumatics, the TNF inhibitors.


METHODS
Qualitative study employing semi-structured interviews of 22 patients diagnosed with rheumatoid arthritis at three hospitals in the region of Stockholm, Sweden. The interviews were conducted from December 1999 to March 2000.


RESULTS
Patients suggest that a basis for priority setting should be need, including priority to persons with severe and/or early disease, and to those not responding to other anti-rheumatics. Some patients believe that age and productivity have to be taken into account in priority setting, while others oppose this view. Some patients want the individual physician to carry out priority setting, while others consider this too arbitrary. Respondents often suggest criteria unfavourable to themselves. Alongside suggestions for priority setting criteria, there is also a notion that, ideally, priority setting should not have to take place at all.


CONCLUSIONS
Patients' views of priority setting are not necessarily influenced by the patients' individual needs and may contribute to the development of priority guidelines. Knowledge of the patients' perceptions of priority setting for a specific treatment might also support patient-provider discussions on priority setting.
Lindblad
Asa Kettis
AK
Dept of Pharmacy, Uppsala University, Uppsala, Sweden. asa.kettis@farmaci.uu.se
Hartzema
Abraham G
AG
Jansson
Lisa
L
Feltelius
Nils
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001294:Attitude to Health; D015195:Drug Design; D005260:Female; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D010344:Patient Advocacy; D011050:Policy Making; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D014409:Tumor Necrosis Factor-alpha