The issue of health service planning regularly hits the headlines. In a speech delivered in October by the Chief Executive of NHS England, Simon Stevens described a “mismatch between resources and patient needs of nearly £30 billion a year by 2020/21”.
This OHE Occasional Paper by Adrian Towse discusses Professor Bengt Jönsson’s observations in a 2011 publication about the role of relative effectiveness research (RE) in the European medicines market and how this could lead to improved efficiency in the development of medicines, the pricing and use of medicines, and of health systems.
Economic thinking and analysis can contribute greatly to designing and evaluating health care policy and practice. There is a growing need to improve the efficiency and sustainability of health care systems everywhere.
The cost of the National Health Service in the United Kingdom now exceeds £l,000m. per year. Ten years ago, when expenditure was less than half this amount, the cost of the Health Service was the source of continued public concern. Cost was "the one aspect of the National Health Service which, since its inception in 1948, has given rise to more critical discussion and controversy than any other single issue". The controversy has now largely died away, and expenditure on the Service is no longer viewed with such alarm or disquiet.
The total expenditure on medicines in the United Kingdom in 1966 was £267 million. Of this £188 million was for medicines prescribed on the National Health Service. The other £79 million was spent by the public mainly for medicines bought without a doctor's prescription. Thus self-treatment still forms an important aspect of medical care, although in terms of cost it accounts for less than half per cent of total consumer expenditure.
Interest is growing in schemes that involve “paying for pills by results”, that is, “paying for performance” rather than merely “paying for pills”. Despite its intuitive appeal, this approach is highly controversial and is disliked by many health care providers, policy makers, and pharmaceutical companies.