Definition of the reimbursable treatment basket and preventive application proposals

The reimbursable treatment basket can only contain those treatments whose effectiveness has been proven. This is for various reasons, including equity, which is essential. This criteria is not enough, however, since the overall benefit that patients are eligible to receive for a treatment always depends on the gravity of their illness. There is therefore no natural limit to the benefit value that may separate those patients for whom the balance between the treatment benefit and disadvantages is favourable from those for whom it is not sensible to prescribe. It is necessary to apply an external restraint acting as either the risk and nature of undesirable effects, or the amount that the community accepts to allocate to funding treatment. Their unproven effectiveness thereby eliminates from the basket those treatments whose value is unknown. This restraint will define the perimeter of reimbursable treatments.