The need for pharmacoeconomic evaluations in the NHS.

New medicines can be cost effective, and the under use of many therapeutic advances has been a cause for concern. Equally, the introduction of certain expensive products onto the market prematurely where adequate clinical studies have not been conducted equally represents an unsatisfactory situation. Many of these products that have reached the market 'too soon' have been for serious conditions where current treatments are inadequate and the new product represents a new hope which may or may not be realised. For some products, studies may have to take place after marketing and a condition for patients receiving treatment is that they are enrolled into a postmarketing study. Ultimately, decisions on the use of such treatments should be made after adequate clinical efficacy studies are available and independent pharmacoeconomic assessment has taken place. Decisions on the use of expensive treatments should be made nationally and not left to local health authorities desperate to balance their budgets.