Bush's 4th veto of his presidency is a good one

[ymu]

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The rest of the world are sensible enough to regulate drug company profiteering

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define and explain that please.

[/ QUOTE ]Well in the UK we have both the Pharmaceutical Price Regulation Scheme, under which companies must repay any profits made from NHS purchasing over and above an agreed amount. We also have NIHCE which looks at the cost-effectiveness of health technologies and gives non-binding recommendations to the NHS about whether certain costly treatments nevertheless provide enough benefit to justify the cost. NIHCE (originally NICE) evolved from regional panels which did much the same thing but didn't always reach the same conclusion as each other, so the national panel was set up to make appraisals more transparent, fair and better funded.

This latter approach is rapidly developing worldwide, with the leaders being the UK, Canada and Australia with Europe and South America rapidly catching up. The basic principle is simple: no matter how much you spend on healthcare, there will always be a ceiling determined by the maximum income that can allocated to healthcare expenditure. Given this, there must be a means to rank health technologies according to the amount of benefit they provide per $ spent (measured from the patient perspective) so that it is the least cost-effective treatments that do not get funding when we hit that ceiling.

The experience in the UK has been that part way through the appraisal process, drug companies frequently drop the price of the technology to the level at which they believe it will come in as cost-effective, although quite often their drug turns out to be largely useless anyway when the evidence is examined, so we wouldn't use it regardless. This is a comedic article from the BMJ advising industry on this process: http://www.bmj.com/cgi/content/full/327/7429/1446 (it's in a section called "Snakes, ladders and spin", with a number of articles worth reading).

Last I heard John Howard (Australian PM) had dismantled their regulatory system in return for a free trade agreement from Bush. Much the same way as the UK Department of Health occasionally circumvents NIHCE advice if the Pharma companies get threatening.