A PURCHASER PERSPECTIVE OF MANAGING NEW DRUGS - INTERFERON-BETA AS A CASE-STUDY

Many new drugs in the future will be very expensive and have major res ource implications. Given current structures and legislation covering the prescribing of drugs, there are no clear means of controlling the use of these drugs to avoid diverting money away from other health car e services and into drug treatment. This paper considers what mechanis ms might be used by a purchaser to manage the introduction of an expen sive new drug and uses interferon beta-1b for treating multiple sclero sis as an example. The most likely mechanism is the prescribing of the drug by a general practitioner on the advice of a neurologist. This w ould achieve a good benefit for the resources invested but would not c ontrol total expenditure. Devolving a limited budget for the drug to a specialist centre so that neurologists may prescribe it directly woul d be preferable, as this would link clinical, prescribing, and budgeta ry responsibility. These issues need to be addressed urgently by purch asers if major disruptions of services are to be avoided.