E-DRUG: Millions for Viagra, Pennies for the Poor

["Gunnar Holmgren" <Gunnar.Holmgren@ich.uu.se>]

E-DRUG: Millions for Viagra, Pennies for the Poor (cont)
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Of course there is much that can be done despite the greed factor in the
priorities of multinational companies. There are three positive factors
that every country and especially the poorest can focus on to reduce their
drug bill:

a. Drug treatment is not always necessary for recovery. Cochrane
estimated that 80% of patients who seek medical help from a doctor will get
better without any drug treatment. The former editor of the New England
Journal of Medicine, Ingelfinger, estimated 85%! Thus alternative
treatments that do no harm e.g. traditional or folk medicine should not be
discouraged for illnesses where drug treatment is not essential. However
the important areas where drug treatment is indispensable (such as TB
treatment and STD therapy) must be clearly defined and identifiable.

b. Most of the major advances in drug therapy were made in the 30
years up to 1965 as was shown very elegantly by Wurtman and Bettiker in
their article in Nature Medicine (Nov. 1995). Very few fundamental advances
in treatment on a similar scale have occurred since then. Thus most
breakthrough drugs that radically alter prognosis in a global perspective
are relatively cheap (apart from anti-retrovirals). The Cochrane reviews
are now identifying the most important key areas where drug treatment has a
sound scientific basis and are also identifying those where the basis is
questionable or where the treatment is even contraindicated.

c. The new policy of an essential drug list and the introduction of
rational use of drugs if applied well will significantly reduce costs.

Gunnar Holmgren, IMCH, Uppsala, Sweden

Email: Gunnar.Holmgren@ich.uu.se  [manually added by moderator; WB]
 
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