Applied pharmacoeconomics

Sanchez, L.A. Lee, J.T, Applied pharmacoeconomics Modeling data from internal and external sources. Am. J. Health-Syst. Pharm. 2000, 57 (2), 146-155. 

Health technology assessment organizations are the government agencies that apply pharmacoeconomic data to make marketing authorization, pricing, and reimbiirsement decisions. 

Pharmacoeconomic studies of other dmgs are fewer and, as with clozapine, rely on less robusr merhods. Risperidone is probably associared wirh lower costs. A Swedish study applying UK costs to patient outcomes showed a reduction in mean direct costs of about 7500 per patient per year (Guest et al, 1996). Other studies, however, show risperidone ro be cost-neutral (Revicki, 1999). There are fewer studies of olanzapine (although there are many publications), and taken together they suggest the dmg is at least cost-neutral with respect to immediate costs (Fichner et al, 1998 Hamilton et al, 1999). 

There is no doubt that the continuing evaluation of the safety of medicines into the post-marketing period is an expanding and stiU developing area of research. Matters relating to safety spread over into efficacy, which together imply risks and benefits which, in the present international climate of healthcare provision, have consequences for outcomes and costs. A whole new field of research - pharmacoeconomics - is in the process of development and it is to be anticipated that many of the methods used for safety evaluation will be modified and applied in this area. 

External reports are most likely going to be manuscripts submitted to peer-reviewed journals. Placement of pharmacoeconomic articles in nonspecialty journals is important but difficult. Some editors do not understand the intrinsic properties of pharmacoeconomic data, and some reviewers will blindly apply statistical constraints that are inappropriate or not valid to humanistic outcomes (e.g. power calculations to measures of the adverse effects of drugs on QOL measures). 

The basic principles of scientific writing and reporting apply to pharmacoeconomic research, and little need be said here. The structure of the paper is the same (Introduction, Methods, Results, Discussion, etc.). It is important to be consistent and appropriate in the use of terminology (e.g. costs is not synonymous with charges , and cost-effectiveness is not a cost-benefit analysis Sanchez and Lee, 1994). New mediums such as the Internet offer new possibilities for publication, dissemination and debate (Medical Outcomes Trust, 2001 (www.outcomes-trust.org) American College of Clinical Pharmacy, 1996). 

This applied discipline of pharmacoeconomics is slowly evolving. Despite its lack of maturity, many people and systems are embracing it as a savior. Although pharmacoeconomics is an important... 

MEDLINE 1965-. Bethesda, MD, U.S.A. National Library of Medicine. Daily. MEDLINE provides specific indexing terms to retrieve pharmacoeconomic information. The descriptor ECONOMICS-PHARMACEUTICAL (MeSH tree number N03-219-390 synonyms pharmaceuticail-economics and pharmacoeconomics) was adopted in 1994 and will retrieve entries as defined in its scope note Economic aspects of the fields of pharmacy and pharmacology as they apply to the development and study of... 

Pharmacoeconomics. URL http //www.dimdee.ac.uk/memo/ memoonly/PHECOO.HTM (accessed October 2005). The aim of this tutorial is to provide an overview of pharmacoeconomics and to show how it can be applied practically to decisions about drug therapy. 

PharmacoEconomics. Auckland, New Zealand Adis International. Monthly. ISSN 1170-7690. Promotes the development and study of health economics as applied to rational drug therapy. 

In today s health care settings, pharmacoeconomic methods can be applied for effective formulary management, individual patient treatment, medication policy determination, and resource allocation. 

Quality patient care must not be compromised while attempting to contain costs. The products and services delivered by today s health professionals should demonstrate pharmacoeconomic value, that is, a balance of economic, humanistic, and clinical outcomes. Pharmacoeconomics can provide the systematic means for this quantification. This chapter discusses the principles and methods of pharmacoeconomics and how they can be applied to clinical pharmacy practice and thereby how they can assist in the valuation of pharmacotherapy and other modalities of treatment in clinical practice. 

Historically, pharmacoeconomic principles and methods have been applied commonly to assist clinicians and practitioners in making more informed and complete decisions regarding drug therapy. For example, pharmacoeconomics can provide critical cost-effectiveness data to support the addition or deletion of a drug to or from a hospital formulary with or without restriction. In fact, the pharmacoeconomic assessment of formulary actions is becoming a standardized part of many pharmacy and therapeutic (P T) committees. 

Conducting a pharmacoeconomic evaluation should be guided by the criteria for quality economic evaluations. " A 10-step process identified by Jolicoeur and associates and four additional steps that I have added can provide readers with guidance for conducting a local pharmacoeconomic study. This process contains 14 fundamental steps for conducting a pharmacoeconomic evaluation in a health care system and can be applied to virtually any therapeutic area or health care service. Although some of these steps are similar to the evaluation criteria detailed earlier in this chapter, they will now be discussed briefly in the context of conducting an evaluation. 

In recent years pharmacoeconomics has been used as a term to describe the identification, measurement and comparison of the costs and consequences of pharmaceutical products and services (Bootman et al 1996). As such, pharmacoeconomics focuses primarily on pharmaceuticals, and attempts to evaluate the economic and humanistic impact of drug therapy. Pharmacoeconomic tools are derived from a variety of sources, including the fields of economics and outcomes research. Quite often the pharmacoeconomist will bring to the development team skills and experience in quality of life, patient satisfaction and other patient-centered measures. Health economists and a pharmacoeco-nomists differ (while the terms are sometimes used interchangeably), in having stronger backgrounds in the theoretical and applied aspects of health economics, respectively. A researcher with solid... 

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