Pharmacoeconomic analysis decision-making

George, B., A. Harris, andA. Mitchell. 2001. Cost-Effectiveness Analysis and the Consistency of Decision-Making Evidence from Pharmaceutical Reimbursement in Australia (1991 to 1996). PharmacoEconomics 19(11) 1103-1109. 

Controversy surrounds the issue of study perspective. Many researchers assert that society is the only relevant and the most appropriate perspective from which to conduct a pharmacoeconomic analysis. However, in the United States, these studies can be very resource-intensive in terms of time and money. Further, organizations may need to focus solely from their own perspectives to obtain the data necessary to inform timely decision making. 

Schecter CB. Decision analysis in formulary decision making. Pharmacoeconomics 1993 3 454-461. 

Although the direct medical costs of anemia are unknown, the direct costs of drug treatment must be weighed with the indirect costs associated with anemia. The costs of laboratory tests used to diagnose anemia, the role of screening for anemia, and the prevention of anemia are aU components that necessitate consideration in the phar-macoeconomic analysis. Anemia practice guidelines within medical subspecialties must take pharmacoeconomics into consideration as they are developed. Additionally, the frequency of blood transfusions must be considered, as it impacts cost and therapeutic decision making in patients. 

The underlying premise of pharmacoeconomic analyses is that fiscal resources are scarce and that there is a need to make decisions based on the relative value of different interventions in creating better health and/or longer life. There are five main analytical techniques used to evaluate the incremental value of products. These are cost-consequence analysis (CCA) cost-effectiveness analysis (CEA) cost-benefit analysis (CBA) cost-minimisation analysis (CMA) and cost-utility analysis (CUA). Although the identification and valuation of the cost component (numerator) of these analyses are similar, it is the identification and valuation of the consequences (denominator) that truly differentiate these analytic techniques. A brief description of each of these techniques follows. 

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