Small change

doi:10.1136/bmj.331.7530.E393

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Douglas Kamerow, editor (dkamerow@bmj.com)

“Change is scientific, progress is ethical; change is indubitable, whereas progress is a matter of controversy.” Bertrand Russell could have been speaking about medicine, where change happens constantly. Whether it is change for the better remains to be seen.

A case in point is our ever-expanding number of new drugs. Most of them are just more expensive versions of existing preparations. Steven Morgan and colleagues (p 511) calculate that 80% of increased prescription costs in Canada are attributable to new “me-too” drugs that don't …