Ethical and Legal Challenges in Resource Allocation for Rare Disease Patients
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Ludlow, P. The European Commission.
The New European Community, Routledge:
; 85-132.
Philippidis, A. Orphan drugs, big pharma.
Human Gene Therapy. 2011; 22(9): 1037-1040.
Wamelink, M. M., et al. The difference
between rare and exceptionally rare: molecular
characterization of ribose 5-phosphate isomerase
deficiency. Journal of Molecular Medicine.
; 88: 931-939.
O'Connor, D. J. Orphan drug
designation–Europe, the USA and Japan. Expert
Opinion on Orphan Drugs. 2013; 1(4): 255-259.
Gammie, T., et al. Access to orphan
drugs: a comprehensive review of legislations,
regulations and policies in 35 countries. PloS
One. 2015; 10(10): e0140002.
Abbasi, M. & Faraji, O. Role of ethics in
fair allocation of health resources. 2013; 121-
Yousefi, M., et al. Methods of resource
allocation based on needs in health systems, and
exploring the current Iranian resource allocation
system. Hakim Journal. 2010; 13(2): 80-90.
Duchange, N., et al. Ethical management
in the constitution of a European database for
leukodystrophies rare diseases. European Journal
of Paediatric Neurology. 2014; 18(5): 597-603.
Kacetl, J., et al. Ethical Questions Linked
to Rare Diseases and Orphan Drugs–A
Systematic Review. Risk Management and
Healthcare Policy: 2020; 2125-2148.
Lenaerts, K. Exploring the limits of the
EU charter of fundamental rights. European
Constitutional Law Review. 2012; 8(3): 375-403.
Hews‐Girard, J., et al. Objectivity in rare
disease research: a philosophical approach.
Nursing Inquiry. 2020; 27(1): e12323.
Rodriguez-Monguio, R., et al. Ethical
imperatives of timely access to orphan drugs: is
possible to reconcile economic incentives and
patients’ health needs? Orphanet Journal of Rare
Diseases. 2017; 12(1): 1-8.
Hyde, R. & Dobrovolny, D. Orphan drug
pricing and payer management in the United
States: are we approaching the tipping point?
American Health & Drug Benefits. 2010; 3(1):
Tambuyzer, E. Rare diseases, orphan
drugs and their regulation: questions and
misconceptions. Nature Reviews Drug
Discovery. 2010; 9(12): 921-929.
Force, U. P. S. T., et al. Guide to Clinical
Preventive Services. U.S. Department of Health
and Human Services.1996.
World Health Organization. International
Classification of Diseases. 9th Revision.1978.
Haffner, M. E. Adopting orphan drugs—
two dozen years of treating rare diseases. New
England Journal of Medicine. 2006; 354(5): 445-
Wästfelt, M., et al. A journey of hope:
lessons learned from studies on rare diseases and
orphan drugs. Journal of Internal Medicine.
; 260(1): 1-10.
Bank, I., et al. Social aspects of genetic
testing for factor V Leiden mutation in healthy
individuals and their importance for daily
practice. Thrombosis Research. 2004; 113(1): 7-
Schieppati, A., et al. Rare diseases: a
global challenge. The Lancet. 2008; 371: 2039-
Dehnavieh, R., et al. Challenges of
determining basic health insurance package in
Iran. Payesh (Health Monitor). 2011; 10(2): 273-
Barham, L. Three NICE thresholds for
cost-effectiveness: does that make sense.
Pharmaphorum. 2016; 25.
Czech, M., et al. A review of rare disease
policies and orphan drug reimbursement systems
in 12 Eurasian countries. Frontiers in Public
Health. 2020; 7: 416.
Farzaneh et al
et al
Farzaneh et al
| J Iran Sci Asso Med Ethi, 2025, Volume 1, Issue 1
Roberts, M., et al. Conceptualizing a
model: a report of the ISPOR-SMDM modeling
good research practices task force–2. Medical
Decision Making. 2012; 32(5): 678-689.
Thokala, P., et al. Multiple criteria
decision analysis for health care decision
making—an introduction: report 1 of the ISPOR
MCDA Emerging Good Practices Task Force.
Value in Health. 2016; 19(1): 1-13.
Moradi, N., et al. Willingness to pay for
one quality-adjusted life year in Iran. Cost
Effectiveness and Resource Allocation. 2019;
(1): 1-10.
Simoens, S. Health technologies for rare
diseases: does conventional HTA still apply?
Expert Review of Pharmacoeconomics &
Outcomes Research. 2014; 14(3): 315-317.
Bravi, F., et al. Hospital network
performance: A survey of hospital stakeholders’
perspectives. Health Policy. 2013; 109(2): 150-
Mobinizade, M. & Fakoorfard, Z.
Allocation of resources for diagnostic and
therapeutic interventions in rare diseases. Health
Technology Assessment in Action. 2021.
Gericke, C. A., et al. Ethical issues in
funding orphan drug research and development.
Journal of Medical Ethics. 2005; 31(3): 164-
McCabe, C., et al. Orphan drugs and the
NHS: should we value rarity? BMJ. 2005;
(7523): 1016-1019.
Pinxten W, Denier Y, Dooms M,
Cassiman JJ, Dierickx K. A fair share for the
orphans: ethical guidelines for a fair distribution
of resources within the bounds of the 10-yearold European Orphan Drug Regulation. Journal
of Medical Ethics. 2012; 38(3):148-53.
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