Is it just to pay premium prices for innovatory products?

Abstract: There has been much discussion recently about 'innovation', or more precisely the lack of it, in the health care sector. The concern has been expressed in terms of national guideline or assessment bodies, such as the NICE in the UK and CDR in Canada, applying strict cost-effectiveness criteria in their decision-making and, therefore, failing adequately to recognise the full benefits that come from innovation. My starting point is that innovation is a good thing; it is something we should encourage and welcome.  If this is the case then premium prices for innovatory products might be appropriate. However, this is potentially a very 'slippery slope' and so, before embarking on such a policy shift, we need clarity of the arguments; something notable by its absence from recent debates on this topic. Authors who have called for premium prices for innovatory products have rarely explored the underlying ethical premise for their claims. The central question in this debate is: Why would some patients (i.e., those receiving benefits delivered by 'innovatory' products) be viewed as more deserving of resources than other patients (i.e., those in need of non-innovatory drugs)?  A justice argument will be presented to answer this question.