Resource allocation
Should healthcare allocation include sustainability?
Open access · cc by · source: Europe PMC
A sustainability principle is needed so drug-price spirals, antibiotic resistance, and shortages do not quietly wreck the values other allocation principles serve.
Key findings
Without sustainability, operational rules (buy the cheaper clinically equivalent drug, etc.) can raise future prices, worsen resistance, or hollow out supply. Shortages are especially bad for antibiotics because of fragmented chains and low margins. The principle only asks allocators to count dynamics their own pattern causes, not every future shock.
Methodology
The authors map how health systems justify scarce-resource decisions, then use three cases—drug-procurement cost dynamics, environmental antibiotic resistance, and drug shortages—to show ‘negative dynamics’. They reply to ethical objections that adding sustainability would clash with existing principles.
Limitations
This is a principle paper, not a budget model. It does not quantify a sustainability weight. Independent shocks (pandemics, crises) are set aside.
How this study connects
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