Legitimacy of funding decisions for cancer medicines: a thematic analysis of stakeholder perspectives

Jessica Pace, Sallie Anne Pearson, Wendy Lipworth

Research output: Contribution to journalMeeting abstractpeer-review


Background: Third party payers facilitate access to costly cancer treatments by subsidising their use. However, it is not possible to fund all therapies or make decisions that all stakeholders agree with. A more realistic aim may be for decisions to be understood and accepted as legitimate by stakeholders. This review examined research into the legitimacy of cancer medicines funding decisions from multiple stakeholder perspectives.

Methods: We searched databases for research or review articles published in English between 2000 and 2014 that focused on aspects of or views about medicines funding decisions. Work that has taken place outside of the cancer context was included, as issues raised were relevant to the funding of cancer medicines. Articles were analysed according to the following themes: the claims for medicines funding made on the system by stakeholders, the extent to which existing processes address these and achieve legitimacy and/or ways to increase the legitimacy of medicines funding decisions.

Results: We identified 52 articles, 20 of which focused on cancer. Two sets of claims emerged: manufacturers, patients and physicians want increased availability of therapies, at a lower cost with more timely access while payers aim to achieve equitable access to healthcare within a fixed budget. Current processes offer opportunities for stakeholder participation, although this is generally at the most basic level of representation. Shortcomings of current processes and ways to address these have been identified but there is little dialogue about the best frameworks for achieving legitimacy.

Conclusions:  Current approaches to achieving legitimacy in medicines funding processes are inadequate, but there is little consensus as to how to rectify this. Efforts to enhance the legitimacy of medicines funding processes are therefore addressing a real need, but are unlikely to achieve their goals unless they are guided by stakeholders and underpinned by empirical and theoretical research.
Original languageEnglish
Article numberP39
Pages (from-to)39
Number of pages1
JournalAsia-Pacific Journal of Clinical Oncology
Issue numberS7
Publication statusPublished - Nov 2014
Externally publishedYes
EventSydney cancer conference (2014) - Sydney, Australia
Duration: 26 Nov 201428 Nov 2014


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