E-drug: Rational use of drugs (cont)
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Dear Colleagues,
I appreciated Foppe van Mil's comments on the (WHO)definition of rational
drugs (as provided Kathy Holloway).
'The rational use of drugs requires that patients receive medication
appropriate to their clinical needs, in doses that meet their own individual
requirements, for an adequate period of time and at the lowest costs to them
and their community.'
However, in the light of the struggle we are currently having in Australia
to preserve our Pharmaceutical Benefits Scheme (PBS) I prefer the terms "at
an affordable cost guaranteeing equitable access" rather than "at the lowest
cost".
What is "affordable" will vary in different countries depending on their
economic circumstances. I have some sympathy for innovative research-based
pharmaceutical manufacturers who say that a relatively wealthy country like
Australia should pay more than the "lowest price" capable of being
negotiated in order to support new drug R&D. (Australian domestic prices of
PBS pharmaceuticals are only about 60% of OECD country averages because of
the negotiating (monopsony) power of our PBS and the stringent use of
economic evaluation to determine listings). In Australia, we have tried to
compensate genuine research-based manufacturers for these lower prices in a
variety of ways (see:
http://www-sph.health.latrobe.edu.au/PBAC/Background.htm).
However, I have no sympathy at all for a pharmaceutical industry (or drug
companies) that will not lower the prices of essential drugs (e.g. AIDS
drugs) for poorer countries and I have only anger for an industry (or drug
companies) that attempt to destroy schemes, such as the Australian PBS, that
were set up to provide affordable and equitable access to a limited list of
life-saving or disease-preventing drugs (via government subsidy).
Cheers
Ken
Dr. Ken Harvey, Senior Lecturer, School of Public Health,
Room 221, Building HS1 (NW9),
La Trobe University, Bundoora, 3086, Australia,
Telephone +61 3 9479 5773,
Facsimile +61 3 9479 1783,
Personal mobile 0419181910,
Internet: http://www-sph.health.latrobe.edu.au/kharvey/
"Ken Harvey" <k.harvey@latrobe.edu.au>
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