oa South African Health Review - Rationing of medicines and health care technology : pooling of resources and purchasing of health care

Volume 2007 Number 1
  • ISSN : 1025-1715



Rationing of medicines and health care technologies has become an important topic globally. Health care budgets are pressurised inter alia by the 'so-called' enhanced capabilities of medicine. As health care technology advances, more patients can potentially benefit from known therapies. Given the inability of any health care system to increase its health care budget indefinitely, choices regarding the allocation of funds have become inevitable. To achieve the best clinical outcomes with available funds, the efficacy, safety and quality of technologies, including medicines, must be ensured, their prices optimised and their appropriate use encouraged.

This chapter not only provides an outline of the processes in South Africa that determine allocation of resources towards such interventions, but based on international experience, it also examines some of the advantages and disadvantages of national drug and technology appraisal systems whose functions extend beyond that of marketing approval agencies. Relevant developments in government policy and legislation as they relate to the establishment of a more efficient and egalitarian health care system is reviewed and considerations for future health care reform are proposed.

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