BMJ 1994;309:54 (2 July)

Letters

Drug rationing in a teaching hospital

EDITOR, - Felix Bochner and colleagues make a useful contribution to the database related to drug utilisation review and pharmacoeconomic outcomes.1 We write to comment on the philosophical position and strategic and operational assumptions in their paper. We believe that budgets can be contained by a process other than rationing by prioritisation, and we present our experience at the Alfred Hospital, Melbourne, to support our assertions. We also comment on the management fallacy inherent in assigning arbitrary budgetary targets for use of pharmaceuticals.

The table shows the raw year on year (June) budgetary data for the hospital over the past six years. Despite a complex caseload (for example, organ transplants, major trauma, burns) we have contained our budget. In the current year this is 5.3% (projected) despite an increase in annual throughput in the hospital of 11.4% to December 1994. 


Budgetary data for Alfred Hospital, Melbourne, showing drug expenditure as
. . . [Full text of this article]


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Relevant Article

Controversies in Treatment: How can hospitals ration drugs? Drug rationing in a teaching hospital: a method to assign priorities
F Bochner, E D Martin, N G Burgess, A A Somogyi, and Gary M H Misan
BMJ 1994 308: 901-905. [Extract] [Full Text]

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