Both health and economic reforms will necessarily affect the way drugs are used - which drugs are chosen, how frequently they are used, how many are consumed and for which reasons. Market liberalization policies can bring with them certain concerns in this regard. Greater freedom and greater economic returns frequently result in increases in both the number of drugs available and in the number of retail outlets. Advertising and promotional activities also tend to increase. These and other factors drive changes in consumption patterns which may be undesirable.
For example, they may emphasize social perceptions focused on the curative aspects of health and can foster a dependency on drugs as a quick solution to health problems. Why spend time and energy preserving health when greater accessibility to a wide number of drugs provides “instant solutions” to health problems?
Rational drug use comprises all areas dealing with the proper selection, storage, and use of medications for therapeutic treatment. But in truth, rational drug use begins far before this because it is promoted by all preventive measures which can ensure health and reduce the need for drugs. Fundamental to the appropriate use of drugs is the concept that medicines should not replace the efforts of patients to maintain their health.
Problems in the area of drug use usually arise due to insufficient knowledge, misinformation, lack of confidence in medical advice, forgetfulness, inadequate access to health services and drugs, or some combination of these. The types of issues encountered cover an extensive range: Improper drug selection and prescribing, lack of patient compliance with therapy, drug overutilization, drug underutilization, unintended therapeutic duplication, drug interactions, disease or allergy contraindications, improper storage resulting in reduced efficacy and possible undesirable reactions. At best these problems result in overspending; at worst they lead to serious and undesirable health consequences as well as to an unacceptable and unnecessary loss of resources in fiscally restrained systems.
Health sector reform seeks to ensure access, quality, an efficiency in the health sector. This requires a continued focus on preventive measures and personal responsibility, as well as efforts to provide the best possible curative services when they are called for. Within health sector reform, the reasons for incorporating activities which promote rational drug use involve both ethics and economics. It is important for each individual to receive maximal curative benefit with minimal risk from medical treatments. The ethical precepts which underlie this goal are valid regardless of any other considerations. But additionally, society needs to maximize health benefits to the population vis-a-vis its drug expenditures. This need forms the link between rational drug use and economic issues, and is the basis of the discussion which follows here.