Published 29 May 2009, doi:10.1136/bmj.b1993
Cite this as: BMJ 2009;338:b1993

Analysis

International experience of paying for expensive medicines

¹ Health Services Research Unit, London School of Hygiene, London WC1E 7HT

NHS patients in England are now allowed to pay for private treatment with drugs that are not funded by the NHS. But as Monica Desai and colleagues describe, it may not be easy to maintain a distinction between public and private care

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

The use of so called top-up payments for drugs that are not available on the National Health Service has caused controversy. Some people believe that it will result in increased access to medications¹ while others warn that such payments contradict the founding principles of the NHS and may lead to greater inequalities.² Mike Richards’s review Improving access to medicines for NHS patients and the government’s response to the review have acknowledged that additional payments, which are already used in a non-uniform manner, must be accepted into practice.^{3 4} The review does, however, recognise that the right to pay for additional specialist care that is not funded by the NHS should be invoked rarely so as to minimise compromising the founding principle of the NHS—namely, to provide a comprehensive service to all on the basis of need, not ability to pay.⁴

The Department of Health has set out a series of safeguards . . . [Full text of this article]

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