Cannabis policy in The Netherlands: Rationale and design of an experiment with a controlled legal ('closed') cannabis supply chain.

Since the Dutch tolerance policy, allowing the purchase of cannabis in 'coffeeshops', is associated with problems of public order and safety as well as health risks, there has been a long debate about legalisation of cannabis production and supply. It was therefore decided to conduct an experiment with a controlled legal ('closed') cannabis supply chain for recreational use. This is of international relevance in view of the current illegal cannabis exports from the Netherlands, the importance of sharing knowledge about the effectiveness of cannabis policies, and the accumulation of evidence needed to evaluate and update international treaties.

[Re-use of medical data for research. What do the Dutch think of the requirement for explicit consent?].

Objective: How do healthcare consumers perceive the use of medical data for scientific research, within the framework of protection of their personal data?

Design: Survey among 731 members of the Healthcare Consumer Panel of the Netherlands Institute for Health Services Research (NIVEL).

Method: A written and online questionnaire was used, consisting of general questions and 4 cases per respondent. The questions concerned the degree of trust respondents have in the use of previously registered data for different kinds of healthcare research, and their willingness to make data available under various conditions without being asked for explicit consent.

[Cost-utility analysis; uncertainties restrict applicability].

Assumptions and choices are inherent to cost-utility analysis, the economic technique that provides a generic measure for the quantification of the efficiency of various health-care services. Uncertainty prevails on many of them: on the definition of the output of health care as health gain, on its expression in quality-adjusted life years (QALYs), on the choice of measurement instruments that should provide comparable information across all disease categories, on the choice of the procedure to value health states, on the relative importance of the judgments of patients and the general public, on the quantification of various types of costs, and on the question as to whether, and then how, future health gains should be discounted. The conclusion is that the results of a cost-utility analysis should be interpreted with caution.