Drug prescribing: a discussion of its variability and (ir)rationality.

Drugs have become an essential part of modern health care. An ever increasing quantity of drugs contributes to people's health. Yet, when unwisely used, drugs may also entail adverse effects and can damage health. Inappropriate or irrational prescription behavior has been reported in the literature. In this paper, I argue that this behavior is a by-product of the variability in prescribing, and make an attempt to understand this variability. Subsequently, the phenomenon of (ir)rational prescribing is studied. A distinction is made between three forms of rationality: that of the physician, the pharmacologist, and the patient. Policy suggestions aiming at improving patients' welfare are offered as well. Three controversial issues in drug prescribing are further discussed, namely the role of advertising, brand names and product variety.