Twenty years ago, the NHS spent around £2.6 billion/year on drugs prescribed in general practice. At that time, DTB hosted a symposium to consider the relationship between drug costs and treatment choices noting that “in a time of severe financial constraints for the NHS it is important that the money available is well spent. In the case of treatment that means the benefits must be worth the cost. There is, however, no agreed way of deciding when a particular health benefit to an individual is worth the cost to the NHS”.1 The symposium concluded that “drug costs …