In Australia we used to have thia wonderful thing called the PBS (Pharmaceutical Benefit Scheme). We still have the PBS, but unfortunately it is no longer so wonderful, I'll get to that later...
The PBS is a major part of our national health service, and billions are spent on it each year. Here is how it used to work:
Certain prescription medications would be government subsidised, so that any citizen or resident of Australia would have access to the drugs they needed at a very low, discount price.
To determine whether any drug is considered fit for the scheme, a committee was set up, they evaluated medications based on several different criteria. The drugs had to be proven to be effective, but they also had to have a high benefit to cost ratio, the committee contained many world respected experts on medicine and on economics. They would take into account all the side effects as well as the effectiveness and price of each medication, and judge the value of that medication based on the level of relief it could give and the seriousness of the condition/s it would work against. Some drugs with multiple purposes would be listed on the PBS for treatment of one condition, but not as a treatment for another condition.
Of course all the major pharmaceutical corporations wanted their drugs listed on the PBS, it meant many millions of dollars of extra sales, and this gave the PBS committee an interesting power, to bargain for cheaper medicine for Australia. Many drugs considered unsuitable for the scheme, because they did not meet the cost/benefit analysis, were listed later, after the drug companies agreed to lower prices.
We do still have the PBS, but our previous, conservative, PM, decided that it was unfair to have this committee with nobody on it to represent the interests of the drug manufacturers. So he installed a pharmaceutical company representative to the committee, and not surprisingly that didn't go down too well. The highly respected and qualified academics who formed the committee saw this as basically putting a fox in charge of the henhouse, and most of them left in disgust after various confrontations, and are now working on similar schemes in scandanavia.
Now we subsidise prescription drugs based purely on effect, and not cost, and always pay the price demanded by the corporations. Not surprisingly, the budget for the PBS has been blown completely, and fewer drugs are now listed.
