Drug therapies expensive

In the case of mental illness, new drug therapies have especially been the focus of attention, partly because psychotropic medication has, for a long time, contributed little to the overall cost of treatment, but also because, with the advent of new generations of antipsychotics and antidepressants, healthcare providers are now searching for justification for the use of these much more expensive treatments. 

Because immunotherapy is expensive, has potential risks, and requires a major time commitment from patients, it should only be considered in select patients. Good candidates include patients who have a strong history of severe symptoms unsuccessfully controlled by avoidance and pharmacotherapy and patients who have been unable to tolerate the adverse effects of drug therapy. Poor candidates include patients with medical conditions that would compromise the ability to tolerate an anaphylactic-type reaction, patients with impaired immune systems, and patients with a history of nonadherence to therapy. 

This situation of escalating costs from improved survival is not new our society has traditionally spent more for incremental (sometimes minor) improvements in care. From an economic perspective, the question becomes how much more and for how long. Every additional dollar spent on health care is another dollar from the Gross Domestic Product (GDP) that cannot be used for other purposes. This opportunity cost of technological improvement will be one of the primary economic and social issues that must be addressed. Pharmacogenomics-based drug therapies will likely provide a test case. Will these new and expensive therapies be rationed if so, on what basis Will our society continue to value improvements in health care above other goods and services such as education, the environment, and Social Security ... 

While an individual s phenotype can directly assess a clinical measureable biologic function of interest (e.g., whether an individual is a fast or slow metabolizer of a certain drug), phenotyping is often expensive and not readily adapted for routine clinical practice. Analysis of genetic information—genotyping—might prove to be more efficient and better able to be adapted to the individualization of drug therapy. 

Efficiency is whether available resources are used wisely for example, drug therapy is inefficient if unnecessary drugs are prescribed or if only expensive drugs are prescribed. 

Mergers, alliances, and other partnerships among health care providers and related businesses will strain ethical and moral boundaries for health care professionals, such as pharmacists Clinical drug therapy management will play an increasingly important role in overall health care as evidence continues to accumulate that drug therapy itself is often the least expensive component of health care. As a result, pharmacists will be paid for and recognized as consultants to other clinicians and to patients. 

When ill persons are offered money over and above expenses to enter a clinical trial of a new drug therapy, the possibility of coercion exists. The reasoning is that if the patient is poor, they might not be able to afford the therapy without entering the trial. Contrast this experience with renally impaired volunteers recruited for a pharmacokinetic study of an antibiotic. Renal failure is not the target of therapy. The subjects receive no therapeutic benefit from participating and are paid as volunteers. 

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