Great medicine--pity about the cost.

The cost of healthcare is increasing inexorably in all countries in the world. Many governments have focused their activities on promoting the effective and economic use of resources allocated to healthcare. Medicines form a small but significant proportion of total healthcare costs and one that has been increasing consistently as new medicines appear into the market place. The writing of a prescription is the most common therapeutic intervention in medicine and yet there is much evidence to suggest that this simple task is not conducted optimally. Healthcare spending contributes to around 14% of growth domestic products in the US economy compared to 7% in the United Kingdom. The UK, spends around £50 billion on healthcare, mainly in the public sector, which represents around £900 per person per year. The amount spent on medicines has consistently been around 10% with around 550 million prescriptions being dispensed annually. Each patient receives on average 9.4 items but this tends to be skewed towards the elderly population. However the proportion spent on medicines is starting to rise and is currently 13% of the total. Medicines expenditure in the UK has increased by an average of 12% per year in the last five years. 81% of the costs are incurred in primary care and this constitute up to 50% of the primary care revenue costs. Within average general hospitals 3% to 5% of the total revenue expenditure is spent on medicines. This increase in expenditure was recently picked up in an independent report produced by the Audit Commission which identified potential for savings of £450 million by promoting good prescribing by general practitioners'. A House of Commons Select Committee enquiry into medicines expenditure was recently convened to examine these increases in costs of medicines2. There are a number of reasons why costs are increasing. These include: * Demographic changes in the population. As the average age in the population becomes older and as the proportion of elderly patients becomes greater their pharmaceutical needs increase * Health screening programmes which have been particularly targeted at the elderly have uncovered previously non-identified diseases which subsequently require treatment. * Improved diagnostic techniques have again uncovered more treatable diseases in these patients. * New medicines are entering the market place on a regular basis frequently offering more effective and less toxic alternatives to existing agents. Invariably these are more costly Pharmacoeconomics has been defined as the measurement of both …