Posted by jono_in_adelaide on October 25, 2012, at 21:02:28
In reply to Re: General healthchecks unlikely To Benefit Patients » jono_in_adelaide, posted by herpills on October 25, 2012, at 8:25:23
> > Cost effectiveness means you use the cheap first line drugs forst (for example, sertaline which costs $4 per month) and reserve the ones costing $400 per month for resistant cases.
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> > It means insurance doesnt accept paying $400 per month for the latest drug when it hasnt been shown to be any more effective than the old cheap ones.
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> > It means prescribing a good quality generic for $10 rather than a brand name for $100
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> > I dont see anything wrong with any of these
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> Nothing wrong with this approach, but the problem is how do we determine when the $4 generic is ditched for something that will be more effective? How long does a patient have to suffer on an ineffective treatment until they are given the green light to try the next, more expensive agent? herpills
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>Well, it works in Australia, and the drug companies play ball - if they can prove that (say) Lexapro is better than generic sertaline, they will be reinbursed a higher price, if they can only show that its equal to it (which is all that they have been able to show) then they recieve the same price for it - and they agree to sell under these terms
Under the national insurance sheme the only drug that is in the restricted catagory is nardil (which costs $200 per month) - the restriction is "depression where phenelzine is the only appropriate drug" - and i guess its upto the doctor to interperate that.
The Australian system lists all the usual antidepressants, about 10 NSAID's, 5 or 6 beta Blockers and god knows how many antibiotics - there is just a structure in place to determine pricing beyond the companys just charging what they want.
The restrictions arnt arduous, and they tend to result in more rational use of drugs (for example quinolone antibiotics are rarely used outside of hospitals in this country, and so resistance to them is rare, compare to the US where levaquin is given out for sinusitis and bronchitis, and resistance to these valuable drugs is common
poster:jono_in_adelaide
thread:1029529
URL: http://www.dr-bob.org/babble/20121018/msgs/1029787.html