Complementing List of ways to improve drug discovery, development, and delivery independent of patents
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Increase primary care
The Heroism of Incremental Care contrasts generalist (low paid) long-term and incremental care with highly paid invasive specialist interventions, but the contrast could also be made with high-priced drugs.
Correcting problems briefly described in Informed Patient? Don’t Bet On It relates to several other interventions mentioned here -- informed patients (and processes triggered by needing to inform them) might help prevent use of unnecessary tests and treatment and reallocate wasteful health care spending. One of the benefits of increasing primary care seems to be better communication with patients.
More would-be competent doctors want to be doctors than are able to due to guild-like restrictions. Makes medical care more expensive (a negative tradeoff for everything else) and directly impacts primary care availability and physician fatigue.
Responsible for much of increased life expectancy over last century, though public opinion thinks 80% attributable to medical technology. Mentioned at end of When Evidence Says No, but Doctors Say Yes, more specific references needed.
Prevent use of unnecessary tests and treatment
Many tests and treatments don't have good evidence, have been disproven, or have more net harm than benefit. See the Right Care Alliance and Right Care Declaration and Producing the right health care: Reducing low-value care and adverse events.
Reduce medical error
Medical error is the third leading cause of death in the US at 250k deaths/year, and that is probably an underestimate.
Reduce physician fatigue
Blog post Fatigued Physicians Make Mistakes and Harm Patients has references. Would reduce medical error, at least.
Reallocate wasteful health care spending
To anything producing better health outcomes. OECD report Tackling Wasteful Spending on Health (blog review) has numerous suggestions.
Stop vendor kickbacks
In some cases intermediary purchasers (such as Group Purchasing Organizations; ex) make their fees from vendors, resulting in a system of effective kickbacks which blocks entry from innovative vendors.