Year of Graduation
Construction of Treatment's Efficiency Criteria (the Case of Innovative Medical Technologies' Introduction in Russia)
In this paper, the process of construction of Treatment's Efficiency Criteria against chronic hepatitis C, rheumatoid arthritis and hepatocellular carcinoma is considered. The relevance of this work is due to the introduction of the risk-sharing agreements' institution in Russian health care, from the point of view of which it is extremely important to establish the boundaries of effective therapy. In contrast to the objectivist position for which the criteria for the effectiveness of treatment are a reflection of the objective biomedical reality, this subject is considered from the point of view of constructivism in the version of the actor-network theory. This conceptualization, describing the process of establishing the effectiveness of therapy as linking the various intermediaries into a single network and stabilizing their identities, makes it possible to identify the spectrum of forces involved in this process and sources of uncertainty. It is concluded that the network constructing the criteria for the effectiveness of treatment consists not only of doctors and their objective methods, but also of patients who are one of the unreliable intermediaries, often bringing breakages to the network. The success of the process of designing criteria for the effectiveness of the treatment of innovative drugs depends on the ability of physicians to establish relationships between various diagnostic methods and the patient's behavior.