The risks from untreated high blood pressure at even mildly elevated levels are well documented in quantitative terms. American insurance companies have since the interwar years required a blood pressure reading from their prospective clients, and figures derived from their analysis of mortality rates according to initial blood pressure, based on a single reading, are shown in Table 1 (Society of Actuaries 1959).
The Office of Health Economics was invited to make a contribution to the celebration of the Golden Jubilee of the ABPI. This booklet is our response. In it we have broadly surveyed British pharmaceutical progress through the last fifty years. We have had to do so within limits of space and time which have constrained our text in two main aspects.
Until the end of the 1960s leukaemia killed about 400 children annually in the United Kingdom. Excluding infant deaths (that is, those occurring in the first year of life) leukaemia alone was responsible for approaching 10 per cent of total child mortality at that time and between 40 and 50 per cent of all child cancer deaths. Amongst adults around 3.000 individuals were, and still are, lost each year as a result of one or another of the various forms of the illness.
Since this monograph was completed, two new stories concerning the safety of medicines have been featured prominently in the British press. The first has been on an American legal case in which damages have been awarded because a medicine taken during pregnancy was alleged to have caused congenital malformations. The second has been based on the fact that the benzodiazepines, when taken for prolonged periods in high dosage, may carry the risk of causing dependency.
The United Kingdom’s performance in the treatment of End Stage Renal Failure reflects, in microcosm, many of the strengths and weaknesses of the National Health Service. On the one hand, UK practice is almost certainly more cost-effective than that of any other country. It has been achieved in this instance by concentration on transplantation and on home rather than hospital dialysis. On the other hand, because of lack of resources, facilities for the most expensive modes of treatment are in considerably shorter supply than in comparable countries.
The purpose of this paper is to describe the nature of Huntington's chorea and to indicate broadly its costs to both society and affected individuals. The latter are usually high because the disease manifests in middle life when people normally experience their peak occupational and familial responsibilities. In fact such is the severity of the disablement it causes in its terminal stages that despite its rarity NHS and social service caring costs alone are estimated to be in the order of £4 million per annum.
This OHE Briefing illustrates some of the difficulties inherent in making accurate international and international comparisons with regard to perinatal mortality, the most sensitive widely collected measure of fetal and maternal wellbeing. It also discusses some of the phenomena which cause, or are closely associated with, danger to life and/or health before and shortly after birth.
Dementia — that is, irreversible and usually progressive destruction of the brain in old age, the causes of which have yet to be identified - is arguably the most significant single problem currently facing the health services. Ten per cent of the population aged 65 years and over (more than 700,000 people) are affected by the condition (s) and of these about half exhibit symptoms of a severe degree.
In the richer nations of Europe and North America the gaining of control over the common infectious illnesses was a long, gradual process. It was initiated by improvements in the diet available to the mass of the people, coupled with public health measures like the provision of clean water supplies and adequate sanitation. Subsequently the attack was driven home by advances in both curative and preventive medicine. Amongst the most significant of these were the development of effective and safe immunising techniques.