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Cheaper drugs and techniques to fulfill chief executive officer perspectives – any choices?

Thomas, Betty E.a; Ledowski, Thomasa,b

Current Opinion in Anesthesiology: April 2019 - Volume 32 - Issue 2 - p 195–199
doi: 10.1097/ACO.0000000000000689
ETHICS, ECONOMICS AND OUTCOME: Edited by Hartmut Buerkle

Purpose of review Against the background of increasing healthcare costs and diminishing budgets, this review aims to present clinicians with ethically viable options to overcome budgetary restraints when seeking to introduce novel products.

Recent findings Healthcare administrators and primary healthcare providers are not unlikely to have different opinions when discussing the introduction of novel products. However, rather than taking a ‘no’ for an answer, doctors may be able to argue for a change – even if this may seem to come at a higher cost. The recent introduction of the reversal agent sugammadex may provide a timely example for the possibility of success ‘against all financial odds’.

Summary Health professionals have the responsibility to deliver high-quality care while acknowledging the financial budget constraints. However, evidence (vs. perception) for outcome benefits of novel drugs or devices should stimulate a robust desire for their timely introduction. Demonstrating actual benefits understandable to administrators, seeking alliances with other medical specialties or patient groups, as well as negotiations with the healthcare industry may all represent viable options. Simply waiting for patents to expire should remain a measure of last resort.

aDepartment of Anaesthesia and Pain Medicine, Royal Perth Hospital

bDiscipline of Anaesthesiology, Medical School, University of Western Australia, Crawley, Western Australia, Australia

Correspondence to Professor Thomas Ledowski, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, 197 Wellington Street, Perth, Western Australia 6000, Australia. Tel: +61 8 92242244; e-mail:

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