Published 11 June 2009, doi:10.1136/bmj.b1935
Cite this as: BMJ 2009;338:b1935

Analysis

Palivizumab and the importance of cost effectiveness

¹ West Midlands Specialised Commissioning Team, Burton on Trent DE14 2WF, ² Royal Shrewsbury Hospital, Shrewsbury SY3 8XQ, ³ University of Oxford, Division of Public Health and Primary Health Care, Oxford OX3 7LF

Prioritising scarce NHS resources is difficult and contentious. Alison Teale, Sanjeev Deshpande, and Amanda Burls discuss the issues surrounding cost effectiveness decisions in the health service and the processes used by a commissioning team in the West Midlands

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

Recent funding decisions on the use of high cost drugs in vulnerable groups have caused problems for the NHS. When working with a finite budget, as commissioners do, a decision to fund one treatment directly reduces the money available for other treatments and services. Clinicians not only have to explain difficult treatment decisions to patients and families, but increasingly find themselves under pressure from the drug industry, pressure groups, and the media to use new treatments. The NHS world class commissioning programme aims to ensure that decisions on funding treatments are robust and based on evidence of cost effectiveness¹; however, that information is not always available to clinicians and commissioners. Inconsistencies between the various agencies providing recommendations and developing policies for the NHS are also unhelpful, as our experience with implementing guidelines on the use of palivizumab show.

Although it is easy to agree that we should use treatments . . . [Full text of this article]

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