It has been suggested (with prior discussion here) that a better approach to new medications would be to require not just that their efficacy be tested against placebos, but also against medications already available to consumers. The British Medical Journal lends support to that position:
In British Columbia most (80%) of the increase in drug expenditure between 1996 and 2003 was explained by the use of new, patented drug products that did not offer substantial improvements on less expensive alternatives available before 1990. The rising cost of using these me-too drugs at prices far exceeding those of time tested competitors deserves careful scrutiny. Approaches to drug pricing such as those used in New Zealand may enable savings that could be diverted towards other healthcare needs. For example, $350m (26% of total expenditure on prescription drugs) would have been saved in British Columbia if half of the me-too drugs consumed in 2003 were priced to compete with older alternatives. This saving could pay the fees of more than a thousand new doctors.Credit: Health Care Renewal.