Many thanks for the comments of Steve Hill and A.J. O'Rourke.
jeanne
-----Original Message-----
From: steve hill [SMTP:[log in to unmask]]
Sent: Monday, June 26, 2000 8:08 AM
To: [log in to unmask]
Subject: Re: is it worth it
<< File: ATT00000.html >>
In the debate about nationalisation, I think some fundamentals are missing.
We can all agree that:
a) duplicating research is wasteful
b) big corporations serve shareholders' interest first and foremost
c) the free-market is not a source of unbounded joy to anyone except
a few Economist readers
However, the challenge is to propose a system that is substantially
better than what we have at present, while remaining achievable.
Nationalisation is not out of date--but it is an ineffective response
to a global industry. If you nationalise drug research in the UK, it
will shift out of the UK. GlaxoSmithKline is not a British entity, it
is global. It can move huge resources around the world as needed--and
it will. And of course, many drug companies aren't based in the UK or
don't do their research in the UK. So, there will still be hundreds
of me-too products coming into the UK; what you need to do is to
tackle the issue of demand, not supply. However, the minute anyone
tries to do that in the UK, we hear screams of "rationing". This is
to miss the point about where the UK, in particular, has some power
over the drug industry: it is a big consumer. By acting as a
demanding customer -- being ruthless about what we will and won't pay
for, basing our decisions on evidence of clinical efficacy and value
(yes, that does mean cost), we can effect change. That (I hope) is
part of the point of NICE. Of course, in order to do that we have to
be willing to refuse to pay for some products. And every time, there
will be at least some patients who will be, or feel that they will
be, worse off for that decision.
Steve
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