40 patients a month: whose treatment comes first

The options

The order shown is not a ranking of preference.

1. Option 1

   Prioritize urgency and expected benefit

   Patients who want short-term health effects but have little data are pushed back.

2. Option 2

   Waiting order first

   Provides predictability but may miss urgent demand.

3. Option 3

   Baseline lottery with urgent exceptions

   Spreads the opportunity but gives up part of the expected benefit.

The situation as it stands

The fictional therapies require per-patient manufacturing, and only 40 patients' worth are produced each month. Decision deadline: 14 days until the next production cycle.

Fictional public hospital consortium

1. Premise 1The fictional therapies require per-patient manufacturing, and only 40 patients' worth are produced each month.
2. Premise 2Urgency, expected benefit, and waiting period rank differently for each person.
3. Premise 3Groups with rare variants are especially short of effectiveness data.

Where it holdsAllocates production slots for presumed approved therapies. It does not replace individual patient consent or clinical judgment.

What is still unknown

1. Unknown 1Range of effects for groups with little data
2. Unknown 2Conflict between investment to expand slots and resources for current treatments

Signals to decide again

• Define the observation, owner, and confirmation window that will establish "the range of effects for groups with little data," and rejudge when new confirmation changes the tradeoff among the options.
• Define the observation, owner, and confirmation window that will establish "the conflict between investment to expand slots and resources for current treatments," and rejudge when new confirmation changes the tradeoff among the options.