Clinical economics

Eisenberg JM, Freund D, Glick H, et al. Clinical economics education in the International Clinical Epidemiology Network. INCLEN Economics Faculty. J Clin Epidemiol 1989 42 689-95. 

Despite much effort, antibiotic resistance continues to increase [61]. Looking back, it is clear that this was an inevitable consequence of antibiotic use [62], Antibiotic resistance, which has been recognized to be an important clinical problem, varies in prevalence from one country to another and among the pathogens themselves. This has great clinical, economic, political and environmental implications worldwide [63]. Strict adherence to the ongoing measures of infection control, education and antibiotic policy should minimize antibiotic resistance [64],... 

Eisenberg, J.M., "Clinical Economics A Guide to the Economic Analysis of Clinical Practices," JAMA, 262, 2879-2886 (1989). 

Conventional evaluation of new medical technologies such as pharmaceutical products includes consideration of efficacy, effectiveness, and safety. The methodology for such analyses is well developed, and studies of safety and efficacy often are required prior to drug marketing. Health care researchers from a variety of disciplines have developed new techniques for the evaluation of the economic effects of clinical care and new medical technologies. Clinicians, pharmacists, economists, epidemiologists, operations researchers, and others have contributed to the field of clinical economics , an evolving discipline dedicated to the study of how different approaches to patient care and treatment influence the resources consumed in clinical medicine. 

The growth of clinical economics has proceeded rapidly as health policymakers have faced a series of decisions about funding new clinical therapies in an era of increasingly constrained health care resources. Assessments of new therapies include an accounting of the resources required for the new therapy, the... 

This chapter discusses the need for applying economic concepts to the study of pharmaceuticals, introduces the concepts of clinical economics and the application of these concepts to pharmaceutical research, reviews some of the methodologic issues addressed by investigators studying the economics of pharmaceuticals, and finally offers examples of this type of research. 

This is a challenging period for the field of clinical economics. Many of the earlier methodologic challenges of the field have been addressed, and researchers have gained experience in implementing economic evaluations in a multitude of settings. This experience has raised new questions for those interested in the development of new clinical therapies and in the application of economic data to the decision-making process. 

Eisenberg JM. Erom chnical epidemiology to clinical economics. J Gen Intern Med 1988 3 299-300. 

Tebaldi M, Heading RC. Clinical economics review functional (non-ulcer) dyspepsia. Aliment Pharmacol Ther 1998 12(l) ll-9. 

Eisenberg JM. 1989. Clinical economics A guide to the economics analysis of clinical practices. JAMA 262 2879. 

McLean W, Gillis J, Waller R. 2003. The BC Community Pharmacy Asthma Study A study of clinical, economic and holistic outcomes influenced by an asthma care protocol provided by specially trained community pharmacists in British Columbia. Can Respir/10 195. 

Links care to the outcomes of interest to consumers of health care, taking into account the multidimensional nature of quality by including clinical, economic, and humanistic outcomes. 

Table 23.1 provides examples of clinical, economic and humanistic outcomes. Each outcome type is not mutually exclusive, for example pain... 

Pharmacoeconomic baseline data should not be considered in isolation, but as one aspect of data that must be considered as a part of the whole. Once the burden of illness information is collected and analyzed, the development team must move to plan for ways to measure and document the clinical, economic and humanistic impact of the new pharmaceutical entity or other intervention. 

Each article was assessed for the type of evaluation and categorized (Table 1). Two factors were considered in determining the type of evaluation the presence of two or more alternatives, and the consideration of both input (costs) and outcomes. Evaluations that included two or more alternatives (i.e., concurrent control group, historical control, preintervention and postintervention design) were considered true analyses, whereas those that did not include a comparison were labeled descriptions. A description of the type of analysis was assigned to the evaluation and included the options of cost or outcome description, cost or outcome analysis, cost and outcome description, and true clinical economic evaluation. Those articles considered true clinical economic evaluations were subcategorized by type, options including cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. 

Yes Cost analysis or outcome analysis True clinical economic analysis Subcategories Cost-minimization analysis Cost-benefit analysis Cost-effectiveness analysis Cost-utility analysis... 

Instead of focusing strictly on the pharmacy profession, the fourth conference addressed the quality of the entire medication-use system. The objectives were to describe—and publicize—the extent of preventable morbidity, mortality, and excess costs resulting from suboptimal medication use to stimulate discussion of the social and economic impact of dysfunction in the medication-use system to develop a reengineered system for medication use that would optimize clinical, economic, and humanistic outcomes to identify strategies that could be used to evaluate and implement the models developed and to foster greater interprofessional collaboration and a shared commitment to optimal medication use. 

One of the primary applications of pharmacoeconomics in clinical practice today is to aid clinical and policy decision making. Through the appropriate application of pharmacoeconomics, practitioners and administrators can make better, more-informed decisions regarding the products and services they provide. Complete pharmacotherapy decisions should contain assessments of three basic outcome areas whenever appropriate clinical, economic, and humanistic outcomes. Traditionally, most drug therapy decisions were based solely on the cfinical outcomes (e.g., safety and efficacy) associated with a treatment alternative. Over the past lOto 15 years, it has become quite popular also to include an assessment of the economic outcomes associated with a treatment alternative. The current trend is also to... 

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