Here's a quick question: if you had to trim the formulary of a hospital down to just 10 adult meds, what would they be? I'm sure a careful and informed individual could make a comprehensive choice based on "Quality of Life Year" information and some epidemiology of the area. Here's what I am thinking:
1) Morphine
2) Aspirin
3) One or two antibiotics (Guess who doesn't remember micro enough to know which ones? I am guessing Cipro/levo and Vancomycin)
5) Insulin
6) Beta-blocker
7) A statin
8) Doxorubicin (What my boss called: the one chemo you'd bring to a desert island)
9) Warfarin
10) Lidocain
Thoughts? It might be a little over-covered for heart disease and under-covered for diabetes. Also, is it even worth it to have a chemo agent, from a utilitarian perspective? I know that's heretical from someone who is interested in cancer research, but how much life are you really adding with one therapy alone?
Also: does Morphine/lidocain deserve a place? Pain management is important, and I didn't want to leave it out. But when there are other diseases being left uncovered, should this be a top priority?
Anyone care to offer an opinion? It's an interesting way of thinking about priorities in U.S. medicine, and pondering how much we take for granted. What medicines are those that we can't make due without?
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