A model for rational introduction of new and expensive medicines

The reported impact of human monoclonal IgM antibody (HA1A) on the mortality rate from Gram-negative bacteraemia aroused considerable interest in its use in Glasgow Royal Infirmary. However, the commercial preparation of HA1A was extremely expensive. With this in mind, the Infirmary's Drugs and Therapeutics Committee introduced a system whereby the commercial preparation of HA1A could be introduced in a controlled fashion, thereby establishing a model which would encourage targeting the prescription of new, highly expensive treatments to appropriate patients. This model provides the clinician with a set of objective criteria to be met before prescribing such a preparation, thus preventing unnecessary increases in the hospital drug budget and justifying using expensive resources.