Health care economics Excellence

Over time, of course, such awareness has continued to grow, although so too has the realization that it should not be cost that drives macro or micro decision-making, but cost-effectiveness. That is, the health-care system needs to achieve a good balance between the resources it uses (the costs) and the outcomes it achieves (the effectiveness). More recent developments, such as the establishment of the National Institute for Clinical Excellence, make abundantly clear both the enduring relevance of economic considerations when deciding how to use health service resources and the pervasive need to balance economic with clinical (and related) objectives. 

The precise role of economic evaluation varies among countries. In the vast majority of jurisdictions the role is confined to decisions about pharmaceuticals only, although the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom also considers devices, medical procedures, and public health interventions. Even among those countries considering only pharmaceuticals, there are variations in policy. In some, all new pharmaceuticals are considered, whereas in others only those drugs having a premium price, or likely to have a major impact on the health care system, are evaluated. 

Funded by the government, the National Institute for Clinical Excellence (NICE) was set up as a Special Health Authority in the United Kingdom in 1999 and, as such, it is a part of the National Health Service (NHS). It was set up to provide the NHS [patients, health professionals, and the public] with authoritative, robust and reliable guidance on current best practice. Its key functions are to appraise the clinical benefits and the costs of those [health care] interventions and to make recommendations. Guidance is issued from each appraisal based on the clinical benefits, cost-effectiveness, and total economic impact on the... 

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. 

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