A healthy dose of disinvestment

Ray N Moynihan
Med J Aust 2012; 196 (3): . || doi: 10.5694/mja12.10011
Published online: 20 February 2012

The challenge of removing what’s useless, harmful or cost-ineffective

It’s easy to forget that the evidence-based approach to medicine is still relatively new, and that a substantial part of health care is not supported by gold-standard evaluation. New procedures, until very recently, have had no requirement for rigorous testing, unlike new drugs. Of the more than 5000  items on the Medicare Benefits Schedule (MBS) today, most “have never been comprehensively assessed for their safety, effectiveness and/or cost-effectiveness”.1 But now many more interventions will be exposed to the chill winds of evaluation. And those that don’t shape up could become targets for “disinvestment” — withdrawal of funding from existing treatments.

  • Ray N Moynihan

  • Byron Bay, NSW.

Competing interests:

No relevant disclosures.


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