What do we gain from the sixth coronary heart disease drug?

doi:10.1136/bmj.327.7426.1237

BMJ 2003;327:1237-1238 (29 November), doi:10.1136/bmj.327.7426.1237

Editorial

What do we gain from the sixth coronary heart disease drug?

Not much: guidelines must consider cost effectiveness

The first 150 words of the full text of this article appear below.

From air travel to patient safety to coronary heart diseaseprevention, people strive to reduce risk to zero. We know thatzero risk is unattainable, yet we pursue perfection. It maybe useful to hold perfection as an ideal,¹ but there can begreat harm in trying to achieve it because near perfection oftenimposes near infinite costs. The closer we get to perfect riskreduction, the more likely it becomes that we could have gota better bang for our preventive buck somewhere else. This appliesacross all activities—and needs to be heeded in healthcare as anywhere else.

For example, air travel is already much safer than most otherforms of travel, so £10m ($17m; €14m) spent on roadsafety would save far more life years than £10m put intotightening airport security. Yet since September 11 much newspending has gone into airport security. In health too . . . [Full text of this article]

Rebecca N Warburton, assistant professor

(rnwarbur@uvic.ca), School of Public Administration, University of Victoria, Victoria, BC, V8W 2Y2 Canada

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