Subject(s)
Antineoplastic Agents , Medical Oncology , Ambulatory Care/organization & administration , Antineoplastic Agents/economics , Antineoplastic Agents/therapeutic use , Cancer Care Facilities , Drug Costs , Evidence-Based Medicine , Feedback , Health Priorities , Hospitalization , Humans , Outcome Assessment, Health Care , United KingdomABSTRACT
Interferon beta is a new and expensive drug for treating multiple sclerosis. One published trial has shown that it reduces the exacerbation rate in patients who have relapsing-remitting disease without important disability. This paper describes the development of a strategy for purchasing the drug in one region of England before its licensing. Purchasers felt unable to decline funding for this marginally effective drug and thereby undertake explicit rationing. To ensure prescribing was within the guidelines, a vast communication network had to be sustained with managers, general practitioners, neurologists, the Multiple Sclerosis Society, and professional advisers in all the purchasing authorities. The workload involved was considerable. The dilemma of rationing in a public service with a high political profile is demonstrated.
Subject(s)
Health Expenditures , Interferon-beta/economics , Multiple Sclerosis/therapy , Attitude of Health Personnel , Group Purchasing , Humans , Multiple Sclerosis/economics , Neurology , State Medicine/economics , United KingdomABSTRACT
Postgraduate training is one of the core functions of every specialty. The Trainee Members Committee of the Faculty of Public Health Medicine audited the quality of training in public health medicine according to guidelines set by the Education Committee of the Faculty. The survey identified several weaknesses in training which need to be remedied by Faculty Members. This audit model would prove useful to other specialties and the benefit of trainee involvement in the Committee structure of the Faculty is highlighted.
