[Sixty years of expensive drugs: from an ad-hoc policy to the structural study of efficiency].
The financing of expensive drugs is not a problem that started yesterday. This article describes the historical developments since the introduction of expensive streptomycin in 1947. The shift from ad-hoc financial compensation of the hospitals to the contemporary financing structure, in which a study of the efficiency is required, is explained. The increasing number of expensive drugs and the increasing extramural use will exert ever-increasing pressure on the overall system of medical care.
Steenhoek
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Erasmus MC-Centrum, Instituut Beleid & Management Gezondheidszorg, Rotterdam. a.steenhoek@erasmusmc.nl
D003362:Cost-Benefit Analysis; D011307:Drug Prescriptions / Q000191:economics*; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006801:Humans; D009426:Netherlands