http://www.nytimes.com/2008/12/03/health/03nice.html
This is a New York Times article on how the National Institute for Health and Clinical Excellence (NICE), a British governmental agency, attempts to quantify the costs and benefits of medication in order to attempt to rationally ration their use.
Regardless of how you feel about the way the British have gone about this, the fundamental problem that we can never afford to do all that might be possible remains. In light of the fact that health care reform is hopefully coming to the U.S., I think it's a useful article to read.
In fact NICE has published guidelines about MS disease-modifying drugs, which I have seen before, but their site (www.nice.org.uk) seems to be malfunctioning at the moment. Their is some info about their guidelines at the U.K. MS Society site at http://www.mssociety.org.uk/get_involved/campaigning/key_campaigns/guidelines.html. I had the impression that NICE tended to think that the cost of the MS DMDs was quite high compared to their perceived level of benefits.
sho