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Controversies in Treatment: How can hospitals ration drugs? Drug rationing in a teaching hospital: a method to assign priorities

Royal Adelaide Hospital, North Terrace, Adelaide, Australia 5000 University of Adelaide, Adelaide, Australia 5005 Department of Clinical and Experimental Pharmacology Health Economics Research Unit, University of Aberdeen, Aberdeen AB9 2ZD Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen AB9 2ZD Centre for Professional Ethics, University of Central Lancashire, Preston PR1 2HE.

When drug budgets are unable to accommodate all new drug requests, a dilemma arises when additional funds become available - which drugs should receive priority? The drug committee at Royal Adelaide Hospital devised a scheme, which they describe here, to rank drug requests to obtain the greatest benefit for the most patients for each dollar spent. We asked a health economist, a clinical pharmacologist, and a moral philosopher to give their perspectives on this form of rationing, and we then gave the authors an opportunity to respond.

The cost of all aspects of health care in developed countries is increasing at an alarming rate.¹ Meeting these costs is becoming more difficult, and a variety of cost containment measures is being considered at national and regional levels.^2,3 The continuing introduction of new technologies and drugs . . . [Full text of this article]

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Relevant Article

Drug rationing in a teaching hospital

A McLean, L Ioannides-Demos, N Tong, and D Topliss
BMJ 1994 309: 54. [Extract] [Full Text]

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