Half a century ago little attention was paid to the risks associated with medical and surgical treatment. The hazards of sickness itself were so obvious, that the considerable risks of medical intervention were more or less taken for granted.
In 1983 almost £6.6 billion was spent on research and development in the United Kingdom. This sum was five times that recorded in 1972 and even when account is taken of the high levels of inflation experienced over the period, this increase still represents real growth of 28 per cent. The resources channelled into research and development now account for 2.55 per cent of gross domestic product and are approximately equivalent to combined central and local government spending on housing or consumer expenditure on tobacco (1983 data).
Great Britain at the suggestion of and in close collaboration with Medizinisch Pharmazeutische Studiengesellschaft (MPS) in the Federal Republic of Germany, OHE is funded entirely by the Association of the British Pharmaceutical Industry and MPS by seven research-based companies in Germany. The Report describes the modern research-based pharmaceutical industry, with particular reference to its structure and activities in seven countries - the Federal Republic of Germany, France, Italy, Japan, Switzerland, the United Kingdom and the United States.
Two years ago, the Office of Health Economics published a research paper describing some of the activities of eighteen European pharmaceutical companies in the Developing Countries in ·1979-80 (Worlock 1982). The same small study group which collected these data have now updated the information, providing statistics for 1981-82. The new study covers a slightly larger number of companies- 22 as against 18.
The performance of the United Kingdom economy has been the subject of much critical comment in recent years. Of course, economic achievement can be viewed from many different perspectives, giving rise to conflicting interpretations of national progress. Furthermore, it is axiomatic that global indicators camouflage a spectrum of experience spanning all degrees of success and failure. Yet, on balance, the censures would appear to be justified.
In the summer of 1982 the Medico-Pharmaceutical Forum held a meeting on 'Disparities in European Medicine'. The aim was to compare and contrast the various aspects of health and medical care in Europe. Disparities were not difficult to find. The conclusion of the meeting endorsed the theme; despite the growth in European communication and development of the EEC, the harmonisation of European medical practice has been very slow, indeed 'convergence is a long way off (Lancet, 1982).
Therapeutic progress in recent decades has made a major contribution to reductions in mortality and has extended control to the symptoms of many chronic diseases. Thus developments in chemotherapy and immunisation have combined with economic, social and environmental improvement to bring about the restructuring of mortality profiles illustrated in Figure 1.
The Office of Health Economics has recently widened its scope to take a special interest in the health care problems of the Poor World, with particular reference to. the role of medicines.
As a contribution to the discussion in this area, OHE is publishing this paper, which was delivered by Dr Arnold Warlock of The Wellcome Foundation Ltd at the 11th Assembly of the International Federation of Pharmaceutical Manufacturers' Associations in Washington in June 1982.