Education And Debate

Scenario analysis of the future of medicines

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6962.1137 (Published 29 October 1994) Cite this as: BMJ 1994;309:1137
  1. H Leufkens,
  2. F Haaijer-Ruskamp,
  3. A Bakker,
  4. G Dukes
  1. Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht University, PO Box 80.082, 3508 TB Utrecht, Netherlands Groningen Institute for Drug Studies, Groningen University, Antonie Deusinglaan 1, 9713 AV Groningen, Netherlands World Bank (Department PHN/Pharmaceuticals), Washington DC, 20433 USA.
  1. Correspondence to: Dr Leufkens.
  • Accepted 12 October 1994

Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples' preconceptions. Scenarios are plausible, not probable or preferable, portraits of alternative futures. A series of four of alternative scenarios were constructed: “sobriety in sufficiency.” “risk avoidance,” technology on demand,” and “free market unfettered.” Each scenario was drawn as a narrative, documented quantitatively wherever possible, that described the world as it might be if particular trends were to dominate development. The medical community and health policy makers may use scenarios to take a long term view in order to be prepared adequately for the future.

Public policy decisions about health care can have repercussions on society that extend for into the future; if they are to be sound they should be based on a solid understanding of the processes that have led to the current situation and some reasoned analysis of the role that these and other factors are likely to play in the foreseeable future. With medicines, this type of policy planning poses peculiarly difficult problems. The existing situation of drug development and treatment is not stable and is not free of conflict and controversy. New discoveries constantly advance the possibilities of drug treatment, but at the same time society is increasingly concerned about rising drug costs, safety issues, and the sometimes irrational use of existing medicines.*RF 1- 3* Research on medical outcomes clearly shows the need for a quantified insight into how drug treatment is actually conducted and what its positive and negative consequences are in terms of health, cost, and value for society as …

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