Formulate, don't formularise

to the community served by the hospital, and thus enlist the recipients and politicians in crucial decision making processes on the delivery ofhealth care.Finally, is the model and its application fair?The answer to this lies partly in whether rationing can be considered as fair.It has been stated that "unfairness lies also in doing things until the money runs out"'"I and that "rationing becomes a morally acceptable option if the need is great enough and if other methods have been exhausted."33In our case the need had become acute, other methods were not sufficient to meet our requirements, and we could not wait for the ultimate cost saving benefits of the drug utilisation review programme to take effect.A method was therefore needed to provide a more equitable approach to this decision making process.