Drugs alone do not create health
ONE EXPECTS doctors to refrain from overdosing the patient. But do they really do that? Apparently not, as is evidenced by experiences in some European countries such as France and Italy. The governments of these nations are spending twice as much on medicines per capita than others without any significant improvement in relative life expectancies.
Prescription medicine sales through pharmacies during the first half of 1993, were only $46 per capita in the UK, as compared with $108 in France, according to figures compiled by the Financial Times and IMS International, a market research group.
In spite of all this, there seems to be little correlation between drug consumption and life expectancy. Life expectancy at birth for males in France is 73 years, compared with 73.2 in the UK.
Large variations
This discrepancy is caused by massive variations in volume and type of drugs prescribed. French doctors prescribe five times as many drugs as their British counterparts, according to a recent study by the Association of the British Pharmaceutical Industry.
The study also found that France spent $27 per capita on cardiovascular drugs in the first half of 1993, as compared with $8 in the UK, though UK has one of the highest rates of heart disease in the world.
Moreover, many of the drugs prescribed in France and Italy are of little proven efficacy. A recent Italian survey rated 10 of the top 50 products in Italy and France, by value of sales, as useless, compared with none in the UK. Though the French like to boast they have one of the best healthcare systems in the world, their system is both unmanageable and expensive.
There is no constraint in France on either consumption or prescription of drugs. Patients can go to the physician of their choice as often as they like and ask for whatever treatment or medicines they desire as they will be reimbursed at the same rate -- 70 per cent of the doctor's fee and 35 to 60 per cent of the cost of most medicines. The doctors, on their part, see patients as often as they can because they get paid for each visit and prescribe many medicines to keep the patients happy.