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The hidden cost of poor-quality healthcare

Choosing the treatment with the best risk-benefit balance and eradicating harmful treatments is an individual and collective challenge.

Access to quality healthcare requires an active policy of improving quality and stamping out bad practices at both individual and collective levels.

The shortcomings of the healthcare system affect the quality of patient care and incur heavy direct and indirect costs. But these costs are largely unknown and ignored. Both in the community and in hospital, inferior quality ranges from lack of care (under-use of resources), to excessive care (over-use of resources) and poor care resulting in adverse effects. If remedying an error costs money, then avoiding errors represents a gain – human gain for the patient, and economic gain for the community.

When it comes to drugs, the system for granting marketing authorisations does not offer the expected guarantees of quality and safety. Certain drugs sometimes remain on the market too long, despite a firmly established unfavourable risk-benefit balance.

Pharmaceutical companies hush up unfavourable clinical data; this strengthens the argument for increased public funding of clinical research and pharmacovigilance.

Expensive new drugs that are not necessarily the best option compared to older, less expensive drugs are aggressively promoted to healthcare professionals and increasingly to the public, resulting in excessive health spending and poor use of resources.

The state and the national health insurance system should concentrate on subsidising only quality care and withdrawing harmful treatments.

©Prescrire September 2010

Source: Numéro spécial "Agir pour l'accès de chacun aux soins de qualité" Rev Prescrire 2010; 30 (322).

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