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In many non-US western countries a fourth hurdle of cost effectiveness analysis has developed before new technologies can be provided. This focuses on the efficiciency (in terms of the cost per QALY) of the technologies in question rather than their efficacy. In England NICE approval requires technologies be made available by the NHS, whilst similar arrangements exist with the Scottish Medical Consortium in Scotland and the Pharmaceutical Benefits Advisory Committee in Australia. A product must pass the threshold for cost-effectiveness if it is to be approved. Treatments must represent value for money and a net benefit to society. There is much speculation[15] that a NICE style framework may be implemented in the USA to ensure Medicare and Medicaid spending is focused to maximise benefit to patients and not excessive profits for the pharmaceutical industry. zometa Allergic reactions can be easily treated and stopped in case you choose appropriate medicine.

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