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Views & Reviews From the Frontline

Beware the cost-benefit analysis

BMJ 2012; 345 doi: (Published 25 July 2012) Cite this as: BMJ 2012;345:e5040
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

The drug industry champions chronic disease. This might be benevolence, but I suspect other motives. Consider the new anticoagulants for atrial fibrillation that do not require blood monitoring. The monthly cost for dabigatran is £75 (€96; $116) and for rivaroxaban is £58, but for 10 years’ treatment this is £9000 and £6860. Consider that there are 10 million people over 65, of whom 5% have atrial fibrillation,1 and we begin to see the scale of the potential income—£4bn in the United Kingdom alone over a decade. Ramp these numbers …

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