pharmacoecononimic..brief brief..

I'm tired of studying for pulmonary... so I decided to write.
A topic that has been circulating in my head (... yes circulating... this is what happens when you stay in healthcare and start applying medical term in your daily language) is pharmacoeconomics.
I love the idea of integrating pharmacy and economic.  In many cases, we have over-used lab work.  We spend way too much money ordering unnecessary tests.  We also spend a lot of money on medications.  However, as much as people hate Pharma... without Pharma, we won't have the world that we have today.  People don't live as long and quality of life would not have been as high as it is now.  However, when you apply the idea of pharmacoeconomic... you start thinking about the cost of drugs associated with outcomes and decide whether it is worth it to pursue the treatment.  The idea bothers me.... can you really put a dollar sign in a patient's survival. Yes, we have ordered many unnecessary tests but some of them have saved life although most of them have gone wasted.  Would the few life that we save be worth the cost?  I personally don't have the answers but politically it might not be a good choice to do so.
A recent report just came out staying to not use mammogram too early. The report indicated there is no additional benefit in performing mammogram too early. This move will definitely cut medical cost related to breast cancer screening.  In addition, report also indicated that self-breast examination offered no benefit.  I personally have been taught and yes I don't see the benefit of doing it unless you are extremely sensitive and doing it religiously.  It's not discouraging patients to do it.  If they feel better doing it, by no means don't stop it.  It's just not an easy test to perform and not many people would adhere to the steps that are provided.  I wonder.. whether this is one of the first step that the government will come out to try cutting medical cost by making the criteria to be a lot more stringent.  Yes, it's cost-saving... but how about the life that could be saved?
As much as I like pharmacoeconomic, I wonder I would ever go into this field.  How would I possibly one day decide to cancel a medication because it's not cost effective for the company?  I pretty much take away a person's ability to fight for his survival... but again, the attractiveness is there.  Figuring out what is the best way to do this... what is the best situation...it's very stimulating.
As for me, I guess if I am diagnosed with a terminal disease, I wonder what I would do... if I knew there is no cure for disease and no matter what my quality of life is going to be extremely low and I become a burden to people around me...I might choose to follow the natural course of the disease because obviously no one would see the person you care suffer.  As much as we hope there is a cure, cure is still very far away...