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.