The World Bank has offered ethical guidance to the governments of

The World Bank has offered ethical guidance to the governments of nations in making priority-setting decisions for pharmaceutical policy. A leading point of this counsel is to respond in only limited ways to patient demands for therapies that are not cost-effective. In every healthcare system, there is a possibility, and, frankly, a reality of overspending in the course of treatment, wasting a nation's limited resources. Patients who independently finance needless treatments that create no further medical costs manifest a less problematic form of overspending, but their treatment nevertheless potentially represents economic dead weight and the diversion of limited resources that could be applied toward necessary ends. Overspending public funds is even more problematic, since public sector spending is systematic and controllable through policy. Most serious is over-medication that harms the patient or others. A leading example of such an erroneous practice is the excessive administration of antibiotics, which, in fostering antimicrobial resistance, may pose as much risk or even greater risk than under-administration of vaccines. Decreasing wasteful medical expenditures is important in the effort to the World Bank's suggested primary goal, which is to maintain a cost-effective pharmaceutical system that maximally, and equitably, improves population health.

Furthermore, the World Bank recommended, as a counterpart to these measures, efforts to improve the population's understanding of pharmaceutical uses and choices. This long-term goal is equally important and equally difficult to achieve in wealthier nations. Better public understanding helps decrease the tension between less-informed wants and well-determined needs. Culturally ingrained maxims, such as a preference for injections, do not change overnight. Furthermore, relying on brand identification can be a rational strategy for information-limited consumers worldwide. Nevertheless, moving citizens to a more informed and empowered position is an ethical obligation, as well as a strategy to reduce costs and minimize risks.

1. The passage is primarily concerned with

A. identifying two practices in medical care that create wasteful spending
B. describing medical research practices that increase costs and risks
C. dispelling myths about unnecessary medical care that drive up costs
D. describing policy points and actions proposed to the governments of nations
E. explaining how the healthcare industry has usually prescribed pharmaceuticals and how such practices will change


2. Which of the following can be inferred from the passage about the excessive administration of antibiotics referred to in the highlighted text?

A. It potentially wastes money and diverts medical resources.
B. It is caused solely by the uninformed wants of patients.
C. It will, if left unchecked, grow to be a larger threat than that of under-administration of vaccines.
D. It benefits the individual receiving treatment at the expense of the well-being of society at large.
E. Its can be attributed to ingrained cultural maxims about what constitutes proper treatment.


3. Which of the following is most likely a benefit of administering medicine in a case as the one described in the highlighted text below?
A leading example of such an erroneous practice is the excessive administration of antibiotics, which, in fostering antimicrobial resistance, may pose as much risk or even greater risk than under-administration of vaccines.

A. It would foster antimicrobial resistance.
B. It would reduce overspending in the long term, though it would contribute to overspending in the short term.
C. It would satisfy a less-informed want on the part of the patient.
D. It would be a relatively less problematic form of overspending on pharmaceuticals.
E. It would be systematic and controllable through policy.


4. The author mentions brand identification in the highlighted text primarily in order to

A. identify the cultural belief that is most responsible for overspending
B. advocate against complete implementation of the World Bank's recommendations
C. indicate an example of a culturally ingrained maxim about medicine
D. illustrate a reasonable factor that inhibits efforts to reduce medical costs
E. provide evidence for the claim that the World Bank's recommendations should be implemented in wealthier countries as well as in less wealthy countries


5. According to the passage, which of the following describes an aspect of nations' use of pharmaceutical therapies?

A. Nations are overly responsive to patients' demands for therapies that incur needless cost.
B. Nations currently fail to address the single greatest cause of financial waste in healthcare.
C. Nations have failed to implement policy controlling public-sector spending of pharmaceuticals.
D. The individuals making policy-setting decisions about pharmaceuticals in nations have been misled by culturally ingrained maxims.
E. The individuals making policy-setting decisions about pharmaceuticals in nations have let political pressures create a situation in which overspending is systematic.