Drugs cost-benefit analysis

Cost-benefit analysis (CBA) is unique among economic evaluations in that it addresses the extent to which a particular course of action, such as a drug treatment or a hospital admission, is economically or socially worth while in the broadest sense. A CBA measures... 

Clinical pharmacology plays no less significant a role in primary health care. That includes emphasis on essential drugs, safe and rational use of essential medicines including their side effects and outcomes, drug data transmission and analysis, and training with emphasis on prevalent diseases. Interactions between orthodox and traditional (complementary) medicines are carefully considered. Cost-benefit analysis is made possible. 

Chapter 9, Psychopharmacology and Health Economics, authored by Dr Ed Snyder, explains the principles of pharmacoeconomics and its applications in psychopharmacology. Readers will find a clear statement of the methodology employed in this still developing field which is of immense importance to day. Major decisions which affect the availability of psychotropic drugs and clinical decisions by individual practitioners are often based on poorly informed concepts of cost-benefit analysis. This chapter will greatly increase the sophistication of many readers on this topic. 

For food safety purposes the overriding aim is that food contamination should be reduced to the lowest practicable level, bearing in mind the potential costs and benefits involved. Since it is difficult to establish cause and effect relationships following long-term (chronic) exposure at low concentrations, it may be necessary to base action on prudence rather than on proven harm to health. However, if this approach is to maintain the confidence of both consumers and producers of food, a rational evaluation of all relevant information is required so that the balance between the risks and benefits of veterinary drugs can be assessed. Information on the incidence of potentially harmful drug residues is fundamental to this cost-benefit analysis so too is the consumption of the commodities involved (particularly for susceptible consumers or those consumers who eat more). Account must also be taken of the potential fall in food production if a drug is controlled or prohibited, and also the animal health and welfare implications that may result from the restriction of an animal medicine for which there may be no effective alternative. 

Is the drug effective The relative safety is balanced in a cost/benefit analysis Unless there is a demonstrable, clear benefit, no drug is sufficiently desirable to deserve approval. The FDA does not approve placebos whose only benefit is subconscious. Compelling evidence of effectiveness, ideally tied to sound theory, is required. 

Destache CJ, Meyer SK, Bittner MJ, Flermann KG, Impact of clinical pharmacokinetic service on patients treated with aminoglycosides a cost-benefit analysis, Ther Drug Mon, 12 419-26. 

Destachc, C.J. Meyer, S.K. Rowley, K.M. Docs accepting pharmacokinetic recommendations impact hospitalization A cost-benefit analysis. Ther. Drug Monit. 1990, 12 (5), 427 433. 

Cost-benefit analysis. In the context of drug development, an investigation in which a therapy is evaluated by measuring all consequences of the therapy (effects, side-effects and costs), converting them into a monetary value, discounting them and adding them. 

Does it work Kirby and Peel introduce us to the concept of therapy economics the comparative analysis of alternative courses of therapy, which is taken to include treatment and drug regimes, in terms of their costs and consequences. The complex calculations include cost-benefit analysis cost-effectiveness analysis cost-minimization analysis the cost of illness, e.g. the annual cost of cardiovascular disease in the UK and quality-of-life measurements, the impact of alternative treatments on patient well-being and expectations. 

Every stage in the search for a new drug is subject to Cost—Benefit Analysis (Cavalla, 1981). Every unnecessary test or delay adds to the cost of the eventual treatment. Hence, as soon as a substance has shown it is both promising and harmless in two laboratory species, nothing short of its administration to Man can give useful new information. Many a seemingly specific and potentially useful substance, chosen on the basis of animal trials, has had to be rejected in the clinic for such reasons as too brief an action, not absorbed from the gut, or serious side-effects not shown earlier. (Parenthetically, the member of a series of new compounds that turned out best in Man has not always been the member that excelled in laboratory experiments.)... 

Measures of Costs and Benefits for Drugs in Cost-Effectiveness Analysis... 

Grabowski, Henry, and C. Daniel Mullins. 1997. Pharmacy Benefit Management Cost-Effectiveness Analysis and Drug Formulary Decisions. Social Science and Medicine 45(4) 535-544. 

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. 

Institute of Statistical Smdies. Technological Assessment of Drug Therapy-Analysis of Cost—Benefit Studies on Pharmaceuticals. Institute of Statistical Studies Tokyo, 1988. 

Another critique of the pharmaceutical industry, published at about the same time, is by Jerry Avom, who describes himself as a pharmacoepidemiologist. Titled Powerful Medicines The Benefits, Risks, and Costs of Prescription Drugs, Avom s analysis is more statistically oriented, but he reaches essentially the same conclusions as Angell. 

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