Abstract
Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes.
Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives.
These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.
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References
Grootendorst P, Pierard E, Shim M. Life-expectancy gains from pharmaceutical drugs: a critical appraisal of the literature. Expert Rev Pharmacoecon Outcomes Res 2009; 9(4): 353–64
Perleth M, Jakubowski E, Busse R. What is 'best practice' in health care? State of the art and perspectives in improving the effectiveness and efficiency of the European health care systems. Health Pol 2001 Jun; 56(3): 235–50
Drummond M, Sculpher MJ, Torrance GW, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press, 2005
Drummond M, Brown R, Fendrick AM, et al. Use of pharmacoeconomics information: report of the ISPOR Task Force on use of pharmacoeconomic/health economic information in health-care decision making. Value Health 2003 Jul; 6(4): 407–16
entre for the Evaluation of Value and Risk in Health. The Tufts Cost-Effectiveness Analysis Registry [online]. Available from URL: https://research.tufts-nemc.org/cear/default.aspx [Accessed 2010 Apr 16]
McMaster University. Health Economic Evaluations Database [online]. Available from URL: http://library.mcmaster.ca/articles/health-economic-evaluations-database [Accessed 2010 Apr 16]
Centre for Reviews and Dissemination. National Health Service Economic Evaluation Database [online]. Available from URL: http://www.york.ac.uk/inst/crd/ [Accessed 2010 Apr 16]
Pharmaceutical Benefits Advisory Committee [online]. Available from URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/Pharmaceutical+Benefits+Advisory+Committee-1 [Accessed 2010 Jul 27]
Medicine Reimbursement Committee [online]. Available from URL: http://www.riziv.fgov.be/drug/nl/drugs/decisions_report/report_crm_cgt/index.htm [Accessed 2010 Jul 27]
National Institute for Health and Clinical Excellence [online]. Available from URL: http://www.nice.org.uk [Accessed 2010 Jul 27]
High Health Authority [online]. Available from URL: http://www.has-sante.fr/portail/jcms/j_5/accueil [Accessed 2010 Jul 27]
Institute for Quality and Efficiency in Health Care [online]. Available from URL: http://www.iqwig.de [Accessed 2010 Jul 27]
Health Care Insurance Board [online]. Available from URL: http://www.cvz.nl [Accessed 2010 Jul 27]
Pharmaceutical Management Agency [online]. Available from URL: http://www.pharmac.govt.nz [Accessed 2010 Jul 27]
Scottish Medicines Consortium [online]. Available from URL: http://www.scottishmedicines.org.uk/smc/CCC_FirstPage.jsp [Accessed 2010 Jul 27]
Dental and Pharmaceutical Benefits Agency [online]. Available from URL: http://www.tlv.se/in-english [Accessed 2010 Jul 27]
Center for Drug Evaluation, Taiwan [online]. Available from URL: http://www.cde.org.tw/eng/default.html [Accessed 2010 Jul 27]
Simoens S. Health economic assessment: a methodological primer. Int J Environ Res Public Health 2009; 6(12): 2950–66
National Centre for Pharmacoeconomics. A review of the cost-effectiveness of sunitinib (Sutent®) under the High Tech Drug Scheme in Ireland [online]. Available from URL: http://www.ncpe.ie/u_docs/doc_129.pdf [Accessed 2010 Jul 27]
Weinstein MC, Zeckhauser R. Critical ratios and efficient allocation. J Public Econ 1973; 2: 147–57
George B, Harris A, Mitchell A. Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics 2001; 19: 1103–9
Laupacis A, Feeny D, Detsky AS, et al. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ 1992; 146: 473–81
Raftery J. Review of NICE's recommendations, 1999–2005. BMJ 2006; 332: 1266–8
Rawlins MD, Culyer AJ. National Institute for Clinical Excellence and its value judgments. BMJ 2004; 329: 224–7
Health Care Insurance Board. Richtlijnen voor farmacoeconomisch onderzoek [guidelines for pharmaco-economic research]. Amstelveen: Health Care Insurance Board, 1999
Webb D. Early assessment of cost-effectiveness. Congress of the European Association for Clinical Pharmacology and Therapeutics; 2009 Jul 12–15; Edinburgh
Grosse SD. Assessing cost-effectiveness in healthcare: history of the $50000 per QALY threshold. Expert Rev Pharmacoecon Outcomes Res 2008; 8: 165–78
National Institute for Health and Clinical Excellence. The guidelines manual 2009. London: National Institute for Health and Clinical Excellence [online]. Available from URL: http://www.nice.org.uk/aboutnice/howwework/developingniceclinicalguidelines/clinicalguidelinedevelopmentmethods/GuidelinesManual2009.jsp [Accessed 2010 Jul 28]
Cleemput I, Neyt M, Thiry N, et al. Thresholds for cost-effectiveness in health care. Brussels: Belgian Health Care Knowledge Centre, 2008
Simoens S. How to assess the value of medicines? Frontiers Pharmacoeconomics Health Outcomes. In press
Drummond M, Evans B, LeLorier J, et al. Evidence and values: requirements for public reimbursement of drugs for rare diseases. A case study in oncology. Can J Clin Pharmacol 2009; 16(2): e273–81
Simoens S. Health economics of market access for biopharmaceuticals and biosimilars. J Med Econ 2009 Sep; 12(3): 211–8
Simoens S, Laekeman G. Applying health technology assessment to pharmaceutical care: pitfalls and future directions. Pharm World Sci 2005 Apr; 27(2): 73–5
Galani C, Rutten FF. Self-reported healthcare decision-makers' attitudes towards economic evaluations of medical technologies. Curr Med Res Opin. Epub 2008 Sep 29
Traulsen JM, Klinke BO. Using health technology assessment to put pharmaceutical care on the political agenda. Pharm World Sci 2004 Apr; 26(2): 61–3
Hoffmann C, Graf von der Schulenburg JM. The influence of economic evaluation studies on decision making: a European survey. The EUROMET Group. Health Pol 2000 Jul; 52(3): 179–92
Neumann PJ, Fang C, Cohen J. 30 years of pharmaceutical cost-utility analyses: growth, diversity, and methodological improvement. Pharmacoeconomics 2009; 27(10): 861–72
Neumann PJ, Greenberg D, Olchanski NV, et al. Growth and quality of the cost-utility literature, 1976–2001. Value Health 2005 Jan–Feb; 8(1): 3–9
Eddama O, Coast J. A systematic review of the use of economic evaluation in local decision-making. Health Pol 2008 May; 86(2–3): 129–41
Drummond M, Barbieri M, Cook J, et al. Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force Report. Value Health 2009 Jun; 12(4): 409–18
Stoykova B, Drummond M, Barbieri M, et al. The lag between effectiveness and cost-effectiveness evidence of new drugs: implications for decision-making in health care. Eur J Health Econ 2003 Nov; 4(4): 313–8
Tilson L, Barry M. Recent developments in Pharmacoeconomic evaluation in Ireland. Expert Rev Pharmacoecon Outcomes Res 2010; 10(3): 221–4
Vinck I, Neyt M, Thiry N, et al. A procedure for the assessment of new medical devices. KCE reports 44A ed. Brussels: Belgian Health Care Knowledge Centre, 2006
Tunis SR, Pearson SD. Coverage options for promising technologies: Medicare's ‘coverage with evidence development’. Health Aff 2006; 25: 1218–30
Cook JP, Vernon JA, Manning R. Pharmaceutical risk-sharing agreements. Pharmacoeconomics 2008; 26: 551–6
Bell CM, Urbach DR, Ray JG, et al. Bias in published cost effectiveness studies: systematic review. BMJ 2006 Mar; 332(7543): 699–703
Miners AH, Garau M, Fidan D, et al. Comparing estimates of cost effectiveness submitted to the National Institute for Clinical Excellence (NICE) by different organisations: retrospective study. BMJ 2005 Jan; 330(7482): 65
Cleemput I, Van WP, Vrijens F, et al. Guidelines for pharmaco-economic evaluation in Belgium. Brussels: Belgian Health Care Knowledge Centre, 2008
GRADE Working Group [online]. Available from URL: http://www.gradeworkinggroup.org/ [Accessed 2010 Jul 27]
SIGN [online]. Available from URL: http://www.sign.ac.uk/[Accessed 2010 Jul 27]
Thurston SJ, Craig D, Wilson P, et al. Increasing decision-makers' access to economic evaluations: alternative methods of communicating the information. Int J Technol Assess Health Care 2008; 24(2): 151–7
Innvaer S, Vist G, Trommald M, et al. Health policy-makers' perceptions of their use of evidence: a systematic review. J Health Serv Res Policy 2002 Oct; 7(4): 239–44
Drummond M, Jonsson B. Moving beyond the drug budget silo mentality in Europe. Value Health 2003 Jul; 6 Suppl. 1: S74–7
Mitton CR, Donaldson C. Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA). Health Policy 2003; 64: 335–48
Wettermark B, Godman B, Andersson K, et al. Recent national and regional drug reforms in Sweden: implications for pharmaceutical companies in Europe. Pharmacoeconomics 2008; 26(7): 537–50
Williams I, McIver S, Moore D, et al. The use of economic evaluations in NHS decision-making: a review and empirical investigation. Health Technol Assess 2008 Apr; 12(7): iii, ix-x, 1-175
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Simoens, S. Use of Economic Evaluation in Decision Making. Drugs 70, 1917–1926 (2010). https://doi.org/10.2165/11538120-000000000-00000
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DOI: https://doi.org/10.2165/11538120-000000000-00000