Promoting cost effective prescribing

doi:10.1136/bmj.311.6997.126b

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Adrian Towse,
Nicholas Wells

Director Office of Health Economics, London SW1A 2DY
Head of Health Economics Glaxo Pharmaceuticals UK, Uxbridge, Middlesex UB11 1BT

Cost effectiveness studies may not be cost effective

EDITOR,--Nick Freemantle and colleagues criticise the NHS for lagging behind Australia and Canada in promoting cost effective prescribing.1 As members of the working group that agreed the British guidance on conducting economic evaluations2 we take issue with their claim that these countries have a preferable approach.

There is no evidence that Australia and Canada have more cost effective prescribing than the United Kingdom. They have centralised reimbursement lists (federal and provincial, respectively), requiring the …