Health care economics cost-effectiveness analysis

Nowadays a drug company has not only to show its paymasters - governments, insurers and so on - that its new prodnct is safe and works, but also that it is cost-effective. In Anstralia, this has been spelled out in legislation. Since 1993, any drng submitted for approval must be accompanied not only by the resnlts of clinical trials bnt also by an economic impact analysis. In 1999, the United Kingdom set np a National Institnte for Clinical Excellence (NICE) to advise the National Health Service on the cost-effectiveness of health care technologies. Other countries ask formally or informally for pharmacoeconomic analysis. Economic impacts can be measured in a variety of ways, for example, cost-effectiveness, cost-utility or full cost-benefit stndies. 

Economic evaluation compares costs and consequences of alternative health care treatments or programs (Drummond et al. 2005). In one form of economic evaluation, cost-benefit analysis, all costs and consequences are valued in monetary terms. However, in health care it is much more common to use cost-effectiveness analysis, where the difference in cost between alternatives is compared with the difference in outcomes measured in units such as life years gained or quality-adjusted life years (QALYs) gained. 

Shah and Jenkins (2000) in a review of mental health economic studies from around the world identified 40 cost-of-illness studies, of which five covered all disorders, one neuroses, two panic disorders and one anxiety. All were from developed countries. There were numerous cost-effectiveness studies but none involving the anxiety disorders specifically. One study in the UK examined the cost-benefit analysis of a controlled trial of nurse therapy for neurosis in primary care (Ginsberg et al, 1984). 

Health economics is concerned with the cost and consequences of decisions made about the care of patients. It therefore involves the identification, measurement, and valuation of both the costs and the consequences. The process is complex and is an inexact science, The approaches to economic evaluation include (1) cost minimization, (2) cost benefit, (3) cost effectiveness, and (4) cost utility analysis (Table 13-2). 

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