Pharmaceutical Ethics

By Sam Salek; Andrew Edgar | Go to book overview
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13
Ethical Problems of Drug
Categorization for
Reimbursement

CHRIS GOOD

Thicket Grove, Maidenhead, Berkshire, UK

As Sir William Osier, the father of modern medicine, said: “The desire to take medicine is perhaps the greatest feature which distinguishes man from animals”. Alone in the wilderness beyond the rigid confines of modern states, people may indulge their predilection to take medicines without any restriction save their ability to obtain the requisite ingredients. The conjoined paternalism of the modern state and the medical profession ensures that people are not allowed to indulge this desire without strict controls. These controls have themselves created problems with pricing and rationing. There is a tacit assumption in making certain medicines only available on prescription that the state and doctor know better than the patient what is best for that patient. This assumes that the state committees and doctors are adequately educated, a big presumption. It also assumes that all diseases have been discovered and named and their aetiology is known. Such pompous paternalism is obviously absurd. It is clear from recent history that there are still many diseases to be discovered and that existing diseases may have a new aetiology, e.g. peptic ulcer and H. pylori.

Modern states have introduced two mutually interactive concepts for the protection of the public, the provision of state health care and the licensing of medicines. Prescription only medicines are generally available as part of free or reimbursed state health care. Non-prescription medicines are

Pharmaceutical Ethics. Edited by S. Salek and A. Edgar. © 2002 John Wiley & Sons, Ltd.

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