Education And Debate

Authors' response

BMJ 1994; 308 doi: (Published 02 April 1994) Cite this as: BMJ 1994;308:907

We have the impression that our commentators are theorists and have not had the responsibility of managing a capped drug budget in a climate which rightly demands the introduction of new - and often very expensive - drugs. Perhaps they failed to appreciate that the model is only one of several strategies to improve drug use; it was developed to respond to our hospital's restrictions on the drug budget, with the consequent need to impose some rationing to avert an even greater crisis than might have otherwise occurred. This was not some theoretical game, the playing of which involved the luxury of prolonged debate, philosophical meanderings, and testing several economic models.

Cam Donaldson has accused us of creating …

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