If the price is rightBMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b2463 (Published 16 June 2009) Cite this as: BMJ 2009;338:b2463
- Ike Iheanacho, editor, Drug and Therapeutics Bulletin
The rationing of medical treatments can be a fiendishly complex subject. But two quotations encapsulate the tensions at the heart of such decision making:
“If it helps at least one person, then it’s worth having.”
“… If the price is right.”
On one hand is the view that an intervention that has been proved to be effective and tolerably safe should not be withheld from people who might benefit from it. The obvious counterargument is that a taxpayer funded system such as the NHS must decide how far it can afford to help all such individuals.
The two positions may be particularly hard to reconcile when it comes to expensive drugs for extending life in people with terminal diseases. Just how hard is shown in Price of Life, an elegant insight into rationing (and the source of both quotations).
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