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A Critical Systematic Review of Budget Impact Analyses on Drugs in the EU Countries

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Abstract

Background

Budget impact analysis (BIA) is a relatively recent technique that is supposed to be complementary to more established economic evaluations (EEs).

Objective

We reviewed the BIAs published on drugs in the EU since December 2008, to assess whether these studies have improved in quality in the last few years.

Methods

We conducted a literature search on the international databases PubMed and EMBASE. The selected articles were screened using a two-step approach to assess (1) their main methodological characteristics and (2) the level of adherence to the latest BIA definition. The assessment was made by two independent reviewers and any disagreement was resolved through discussion.

Results

Eventually, 17 articles were reviewed. Thirteen referred to a stand-alone BIA not accompanying a full EE, only nine focussed on a new treatment, 15 were sponsored by the manufacturer of the drug of reference, all but one claiming savings for healthcare budgets. The quality of methods was poor in many of the studies, and only a few of them attempted to estimate real local costs in a credible way. Therefore, the crucial items that in theory make a BIA different from other types of EEs were often the major points of weakness of the studies reviewed.

Conclusions

Our review confirmed that the BIA is not yet a well-established technique in the literature and many published studies still fail to reach an acceptable quality. In particular, BIAs funded by pharmaceutical companies appear to be tailored to show short-term savings induced by new, highly priced products.

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References

  1. Trueman P, Drummond M, Hutton J. Developing guidance for budget impact analysis. Pharmacoeconomics. 2001;19(6):609–21.

    Article  CAS  PubMed  Google Scholar 

  2. Mauskopf JA, Sullivan S, Annemans L, et al. Principles of good practice for budget impact analysis: report of the ISPOR task force on good research practices-budget impact analysis. Value Health. 2007;10(5):336–47.

    Article  PubMed  Google Scholar 

  3. Marshall DA, Douglas PR, Drummond M, et al. Guidelines for conducting pharmaceutical budget impact analyses for submission to public drug plans in Canada. Pharmacoeconomics. 2008;26(6):477–95.

    Article  PubMed  Google Scholar 

  4. Orlewska E, Gulácsi L. Budget-impact analyses: a critical review of published studies. Pharmacoeconomics. 2009;27(10):807–27.

    Article  PubMed  Google Scholar 

  5. Garattini L, Van de Vooren K. Budget impact analysis in economic evaluation: a proposal for a clearer definition. Eur J Health Econ. 2011;12(6):499–502.

    Article  PubMed  Google Scholar 

  6. De Pouvourville G, Ulmann P, Nixon J, et al. The diffusion of health economics knowledge in Europe: the EURONHEED (European Network of Health Economic Evaluation Databases) Project. Pharmacoeconomics. 2005;23(2):113–20.

    Article  PubMed  Google Scholar 

  7. Mauskopf J. Prevalence-based economic evaluation. Value Health. 1998;1(4):251–9.

    Article  CAS  PubMed  Google Scholar 

  8. Atkins KE, Shim E, Carroll S, et al. The cost-effectiveness of pentavalent rotavirus vaccination in England and Wales. Vaccine. 2012;30(48):6766–76.

    Article  PubMed  Google Scholar 

  9. Geitona M, Carayanni V, Petratos P. Economic evaluation of opioid substitution treatment in Greece. Heroin Addict Relat Clin Probl. 2012;14(3):77–88.

    Google Scholar 

  10. Fragoulakis V, Kourlaba G, Goumenos D, et al. Economic evaluation of intravenous iron treatments in the management of anemia patients in Greece. Clin Econ Outcomes Res. 2012;4:127–34.

    Google Scholar 

  11. Bager P, Dahlerup JF. The health care cost of intravenous iron treatment in IBD patients depends on the economic evaluation perspective. J Crohns Colitis. 2010;4(4):427–30.

    Article  PubMed  Google Scholar 

  12. Purmonen TT, Auvinen PK, Martikainen JA. Budget impact analysis of trastuzumab in early breast cancer: a hospital district perspective. Int J Technol Assess Health Care. 2010;26(2):163–9.

    Article  PubMed  Google Scholar 

  13. Cicchetti A, Ruggeri M, Gitto L, et al. Extending influenza vaccination to individuals aged 50–64: a budget impact analysis. Int J Technol Assess Health Care. 2010;26(3):288–93.

    Article  PubMed  Google Scholar 

  14. De Salas-Cansado M, Cuadros M, Del Cerro M, et al. Budget impact analysis in Spanish patients with Dupuytren’s contracture: fasciectomy vs. collagenase Clostridium histolyticum. Chir Main. 2013. pii: S1297-3203(13)00032-2.

  15. Simoens S, Laekeman G, Decramer M. Preventing COPD exacerbations with macrolides: a review and budget impact analysis. Respir Med. 2013. pii: S0954-6111(12)00506-9.

  16. Gordon J, Evans M, McEwan P, et al. Evaluation of insulin use and value for money in type 2 diabetes in the United Kingdom. Diabetes Ther. 2013 (Epub ahead of print).

  17. Jiang Y, Gauthier A, Annemans L, et al. A public health and budget impact analysis of vaccinating at-risk adults and the elderly against pneumococcal diseases in Germany. Expert Rev Pharmacoecon Outcomes Res. 2012;12(5):631–43.

    Article  PubMed  Google Scholar 

  18. Avgerinou G, Bassukas I, Chaidemenos G, et al. Budget impact analysis of ustekinumab in the management of moderate to severe psoriasis in Greece. BMC Dermatol. 2012;12:10.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Dee A, Hutchinson M, De La Harpe D. A budget impact analysis of natalizumab use in Ireland. Ir J Med Sci. 2012;181(2):199–204.

    Article  CAS  PubMed  Google Scholar 

  20. Thorlund K, Druyts E, El Khoury AC, Mills EJ. Budget impact analysis of boceprevir and telaprevir for the treatment of hepatitis C genotype 1 infection. Clinicoecon Outcomes Res. 2012;4:349–59.

    PubMed Central  PubMed  Google Scholar 

  21. Rønborg SM, Svendsen UG, Micheelsen JS, et al. Budget impact analysis of two immunotherapy products for treatment of grass pollen-induced allergic rhinoconjunctivitis. Clinicoecon Outcomes Res. 2012;4:253–60.

    PubMed Central  PubMed  Google Scholar 

  22. Fragoulakis V, Kourlaba G, Maniadakis N. Economic evaluation of statins in high-risk patients treated for primary and secondary prevention of cardiovascular disease in Greece. Clinicoecon Outcomes Res. 2012;4:135–43.

    PubMed Central  PubMed  Google Scholar 

  23. Gazzard B, Hill A, Anceau A. Cost-efficacy analysis of the MONET trial using UK antiretroviral drug prices. Appl Health Econ Health Policy. 2011;9(4):217–23.

    Article  PubMed  Google Scholar 

  24. Guest JF, Concolino D, Di Vito R, et al. Modelling the resource implications of managing adults with Fabry disease in Italy. Eur J Clin Invest. 2011;41(7):710–8.

    Article  PubMed  Google Scholar 

  25. Guest JF, Jenssen T, Houge G, et al. Modelling the resource implications of managing adults with Fabry disease in Norway favours home infusion. Eur J Clin Invest. 2010;40(12):1104–12.

    Article  PubMed  Google Scholar 

  26. Purmonen T, Nuttunen P, Vuorinen R, et al. Current and predicted cost of metastatic renal cell carcinoma in Finland. Acta Oncol. 2010;49(6):837–43.

    Article  PubMed  Google Scholar 

  27. Gani R, Griffin J, Kelly S, Rutten-van Mölken M. Economic analyses comparing tiotropium with ipratropium or salmeterol in UK patients with COPD. Prim Care Respir J. 2010;19(1):68–74.

    Article  PubMed  Google Scholar 

  28. Colin X, Lafuma A, Costagliola D, et al. Modelling the budget impact of darunavir in the treatment of highly treatment-experienced, HIV-infected adults in France. Pharmacoeconomics. 2010;28(Suppl 1):183–97.

    Article  PubMed  Google Scholar 

  29. Taylor DCA, Chu P, Rosen VM, et al. Budgetary impact of varenicline in smoking cessation in the United Kingdom. Value Health. 2009;12(1):28–33.

    Article  PubMed  Google Scholar 

  30. Launois R, Payet S, Saidenberg-Kermanac’h N, et al. Budget impact model of rituximab after failure of one or more TNFalpha inhibitor therapies in the treatment of rheumatoid arthritis. Joint Bone Spine. 2008;75(6):688–95.

    Article  PubMed  Google Scholar 

  31. NICE. Methods guide. Assessing cost impact. http://www.nice.org.uk/media/99A/F8/Costing_Manual_update_050811.pdf (Accessed 20 Aug 2013).

  32. Garattini L, Koleva D, Casadei G. Modeling in pharmacoeconomic studies: funding sources and outcomes. Int J Technol Assess Health Care. 2010;26(3):330–3.

    Article  PubMed  Google Scholar 

  33. Drugs and devices look more effective in studies sponsored by industry. BMJ. 2012;345:e8386.

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Conflict of interest

All authors declare no conflicts of interest.

Author contributions

All authors contributed to the conception and design of this work, commented on drafts and approved the final manuscript. Silvy Duranti and Sandro Curto acted as independent reviewers of the literature and abstracted the studies, Kate van de Vooren wrote the manuscript and Livio Garattini supervised all of the study and acts as guarantor for the content of the paper.

Study funding

No funding was received for the study.

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Authors and Affiliations

  1. CESAV, Center for Health Economics, IRCCS Institute for Pharmacological Research ‘Mario Negri’, Via Camozzi 3, 24020, Ranica, Italy

    Katelijne van de Vooren, Silvy Duranti, Alessandro Curto & Livio Garattini

Authors
  1. Katelijne van de Vooren
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  2. Silvy Duranti
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  3. Alessandro Curto
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  4. Livio Garattini
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Corresponding author

Correspondence to Livio Garattini.

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van de Vooren, K., Duranti, S., Curto, A. et al. A Critical Systematic Review of Budget Impact Analyses on Drugs in the EU Countries. Appl Health Econ Health Policy 12, 33–40 (2014). https://doi.org/10.1007/s40258-013-0064-7

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  • DOI: https://doi.org/10.1007/s40258-013-0064-7

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