[The risks of suboptimal medication prescribing resulting from economic restraints]

The risks of a less than optimum provision of drugs are shared between patients, medical staff, health insurances and the society as a whole. Often, though, they are unavoidable, sometimes due to legal constraints. Taking multiple myeloma, iron deficiency, and macula degeneration as examples it will be demonstrated that the optimal supply with drugs frequently involving off-label and not reimbursable drugs - cannot only benefit the patient, but can also be cost-saving for the health insurances. The most recent endeavours by the German government to restrain drug expenditures have remained ineffective. Nonetheless, it is expected from patients and physicians alike to bear an ever-increasing share of the health care costs. This problem has no universal solution. Common efforts of all participants in health care are necessary to find a way to evade the explosion of health care costs and to ensure continuous funding of drugs. It is important, however, that patients not be denied access to (often life-lengthening) drugs because of legal ramifications.