The cost and cost-effectiveness of PPIs

Abstract

Background: Evidence-based medicine (EBM) has stim-ulated a proliferation of clinical guidelines and prescrib-ing protocols which aim to increase quality and improve equity of healthcare through the standardisation of treatment and access to resources. The contain-ment of rising prescribing costs is a major concern of European healthcare systems, which has led to a more overt rationing of resources. However, prescribing guidelines and cost-containment strategies reduce the capacity of health professionals to involve patients in discussion and choice of treatment and consequently work against the objectives of patient-centred medicine (PCM), which are a priority of current UK healthcare policy. Little is known about the impact of prescribing guidelines or cost-containment strategies on the practice of medicine in the primary care sector, their effect on relations between doctors and patients, and the ways in which laymen and professionals evaluate and respond to strategies for more ‘rational’ prescribing A...