Values assessments societal costs

Assessing costs and consequences—the value of a pharmaceutical product or service—depends heavily on the perspective of the evaluation. Common perspectives include those of the patient, provider, payer, and society. A pharmacoeconomic evaluation can assess the value of a product or service from single or multiple perspectives. However, clarification of the perspective is critical because the results of a pharmacoeconomic evaluation depend heavily on the perspective taken. For example, if comparing the value of alteplase (tissue plasminogen activator, or tPA) with that of streptokinase from a patient or societal perspective, tPA may be the best-value alternative because a 1% reduction in mortality rates is observed in this large population. Yet, from a small community hospital s perspective, streptokinase may represent a better value because it provides similar outcomes for less money. Once the perspective is clear, a full evaluation of the relevant costs and consequences can begin. Again, perspective is critical because the value placed on a treatment alternative will be dependent heavily on the point of view taken. 

The term cost is also used to assess the effect of actions or decisions. This may be on a personal level What he said was wrong, and it cost him his job), or on a corporate or even societal level The war was won, but at great cost). In this use of the term, cost can be difficult to quantify, let alone measure. Cost then becomes an ambiguous number with an unknown value or a number that is constantly varying (and being argued about). And while the value (the price) of the effects can be debated, the effects themselves are real. We simply do not have the means to measure and quantify them. 

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