Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
A physician outlines the RAND Health Insurance Experiment and its conclusion that the deductible feature of consumer-directed health plans can reduce health care spending significantly.
Consumer-directed health plans will result in a more responsive and sustainable health care system in which patients will take more responsibility for management of their chronic conditions.
The conventional quality-adjusted life years approach to resource allocation has greater societal value if it is distributed among many rather than concentrated on a few, assuming that severity of illness is the same.