Abstract:
:The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficiency but also with the more simplistic goal of remaining within their annual budgets. These two objectives are not necessarily consistent. This paper examines the issue of affordability, the relationship between affordability and efficiency and builds the case for why there is a growing need for budget impact models to complement economic evaluation. Guidance currently available for such models is also examined and it is concluded that this guidance is currently insufficient. Some of these insufficiencies are addressed and some thoughts on what constitutes best practice in budget impact modelling are suggested. These suggestions include consideration of transparency, clarity of perspective, reliability of data sources, the relationship between intermediate and final end-points and rates of adoption of new therapies. They also include the impact of intervention by population subgroups or indications, reporting of results, probability of re-deploying resources, the time horizon, exploring uncertainty and sensitivity analysis, and decision-maker access to the model. Due to the nature of budget impact models, the paper does not deliver stringent methodological guidance on modelling. The intention was to provide some suggestions of best practice in addition to some foundations upon which future research can build.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Trueman P,Drummond M,Hutton Jdoi
10.2165/00019053-200119060-00001subject
Has Abstractpub_date
2001-01-01 00:00:00pages
609-21issue
6eissn
1170-7690issn
1179-2027journal_volume
19pub_type
杂志文章,评审abstract::Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, with an estimated prevalence rate in the general population of 10-15% in industrialised countries. Although IBS is not a life-threatening disease, it contributes significantly to a large segment of healthcare resource consu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624010-00002
更新日期:2006-01-01 00:00:00
abstract::Economic analysts are increasingly likely to rely on systematic reviews and meta-analyses of health state utility values to inform the parameter inputs of decision-analytic modelling-based economic evaluations. Beyond the context of economic evaluation, evidence from systematic reviews and meta-analyses of health stat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0670-1
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the cost effectiveness of fluvoxamine compared with tricyclic antidepressants (TCAs) in the treatment of patients with depressive episodes. DESIGN AND SETTING:A Markov process model was constructed to model the effectiveness, as measured by time without depression, ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814040-00009
更新日期:1998-10-01 00:00:00
abstract::Health economic modelling studies are of interest to many parties with different responsibilities and diverging interests. Therefore, it is obvious that recognising the relevance of statistical uncertainty and dealing with it appropriately are required to obtain unbiased results from health economic modelling studies,...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422120-00001
更新日期:2004-01-01 00:00:00
abstract::The National Institute for Health and Care Excellence (NICE) invited Pfizer, the manufacturer of inotuzumab ozogamicin (henceforth inotuzumab), to submit clinical- and cost-effectiveness evidence for inotuzumab as part of NICE's single technology appraisal process. The Centre for Reviews and Dissemination and the Cent...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-019-00779-4
更新日期:2019-09-01 00:00:00
abstract::About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been i...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119020-00003
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Patients with cancer-associated neutropenia are at high risk of developing severe infections which can be fatal if treatment is not promptly administered. For this reason, fever is treated as soon as possible with broad spectrum antibacterial therapy. The objective of this study was to conduct a cost analysis...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199915010-00006
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:A cost-effectiveness analysis of oral capecitabine versus intravenous bolus 5-fluorouracil/l-leucovorin (FU/LV) as adjuvant therapy in patients with stage 3 colon cancer was performed from a Japanese healthcare payer perspective. METHODS:Adjuvant therapy comprised 24 weeks of treatment with either oral capec...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11310110-000000000-00000
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Currently, the most popular hospital payment method in China is fee-for-service (FFS) with a global budget cap. As of December 2009, a policy change means that heart stents are covered by public health insurance, whereas previously they were not. This policy change provides us an opportunity to study how a c...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-013-0079-9
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Simulation models utilizing real-world data have potential to optimize treatment sequencing strategies for specific patient subpopulations, including when conducting clinical trials is not feasible. We aimed to develop a simulation model to estimate progression-free survival (PFS) and overall survival for fi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00951-1
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Interventions in health care often not only have an effect on patients, but also on their informal caregivers. Caregiving can have a profound impact on the health and wellbeing of carers. Ignoring these spillovers in economic evaluations risks labelling interventions mistakenly as cost-effective, at the expe...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0724-4
更新日期:2019-04-01 00:00:00
abstract::There is a global perspective to the economic consequences of diabetes, which is illustrated in the many publications now being produced on this subject. Because of the higher prevalence of type II diabetes, its impact is greater than that of type I diabetes in both developed and developing countries (but particularly...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199500081-00017
更新日期:1995-01-01 00:00:00
abstract::Fluconazole (FLU) is an alternative to amphotericin B (AMB) for the treatment of candidemia in non-neutropenic patients. This agent has similar clinical efficacy but significantly reduced adverse effects compared with AMB. Using the database from a Canadian randomised multicentre comparative trial of FLU versus AMB in...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.2165/00019053-199813050-00004
更新日期:1998-05-01 00:00:00
abstract::This study evaluated the cost utility of adding interferon-alpha 2b to conventional treatment in patients with multiple myeloma. It also provides a methodology for transforming complex quality-of-life profiles into a single index value on the conventional 0 to 1 quality-adjusted life-year scale (QALY). From 1990 to 19...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-199712010-00009
更新日期:1997-07-01 00:00:00
abstract::The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of denosumab (Amgen Inc., UK) to submit evidence for the clinical and cost effectiveness of denosumab for the prevention of fragility fractures in post-menopausal women, as part of the Institute's single technology appraisal (STA...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11589310-000000000-00000
更新日期:2011-11-01 00:00:00
abstract::Total hip arthroplasty (THA) is a major orthopaedic procedure with a high risk of postoperative thromboembolism. Increasing demand for this type of surgery, together with its high cost, has led to examination of means by which the cost of THA may be minimised. Current clinical opinion favours the use of suitable pharm...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610020-00009
更新日期:1996-08-01 00:00:00
abstract::The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements fo...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200220070-00002
更新日期:2002-01-01 00:00:00
abstract::The progressive increase in the prevalence of obesity and aging in the population is resulting in increased healthcare and disability spending. The burden of obesity is particularly relevant in old age, due to accumulating co-morbidities and changes in body composition. Sarcopenic obesity, a mix of over- and under-nut...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0237-8
更新日期:2015-07-01 00:00:00
abstract:CONTEXT:This study assesses if, and how, existing methods for economic evaluation are applicable to the evaluation of personalized medicine (PM) and, if not, where extension to methods may be required. METHODS:A structured workshop was held with a predefined group of experts (n = 47), and was run using a modified nomi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-014-0211-5
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:In Australia, many patients who are initiated on asthma controller inhalers receive combination inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA) despite having asthma of sufficiently low severity that ICS-alone would be equally effective and less costly for the government. METHODS:We conducted a ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0731-5
更新日期:2019-02-01 00:00:00
abstract::As part of its Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of evolocumab (Amgen) to submit evidence on the clinical and cost effectiveness of evolocumab. The appraisal assessed evolocumab as monotherapy or in combination with a statin...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-016-0472-2
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:Dengue disease poses a great economic burden in Malaysia. METHODS:This study evaluated the cost effectiveness and impact of dengue vaccination in Malaysia from both provider and societal perspectives using a dynamic transmission mathematical model. The model incorporated sensitivity analyses, Malaysia-speci...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0487-3
更新日期:2017-05-01 00:00:00
abstract::Since the inception of the National Health Service in 1948, successive British governments have taken various measures to restrain the growth of the medicines bill. A total of 10 different measures have been introduced with very limited success. The most effective measures have been those directed at increasing the le...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199610030-00003
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:The COUGAR-02 trial recently showed survival and quality-of-life benefits of docetaxel and active symptom control (DXL + ASC) over active symptom control (ASC) alone in patients with refractory oesophagogastric adenocarcinoma. AIM:The aim of this study was to conduct an economic evaluation conforming to Nat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0324-5
更新日期:2016-01-01 00:00:00
abstract::Lung cancer remains the leading cause of cancer-related death and economic burden worldwide. Despite the heavy toll of lung cancer, multiple new advances have improved patient outcomes, largely through precision medicine and targeted therapy. The associated rising economic burden however may impact the uptake of novel...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-017-0563-8
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Mixture modelling is increasingly being considered where a potential cure leads to a long life. Traditional methods use relative survival models for frail populations or cure models that have improper survival functions with theoretical infinite lifespans. Additionally, much of the work uses population dat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-019-00867-5
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to estimate the per-patient-per-month (PPPM) costs of medications in the six Medicare Part D protected classes based on findings among Medicare and dual eligible beneficiaries with drug coverage before the enactment of the benefit. DESIGN:Data were from the Thomson Medstat Mar...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624003-00007
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Results from the PROVE IT trial suggest that patients with acute coronary syndrome (ACS) treated with atorvastatin 80 mg/day (A80) have significantly lower rates of cardiovascular events compared with patients treated with pravastatin 40 mg/day (P40). In a genetic post hoc substudy of the PROVE IT trial, the...
journal_title:PharmacoEconomics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40273-013-0054-5
更新日期:2013-06-01 00:00:00
abstract::Several randomised comparative trials have shown that granulocyte colony-stimulating factor (G-CSF) reduces the duration of neutropenia, hospitalisation and intravenous antibacterial use in patients with cancer who are receiving high-dosage antineoplastic therapy. However, one area that has received less attention is ...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199711060-00005
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:Bipolar disorder has a significant impact upon a patient's quality of life, imposing a considerable economic burden on the individual, family members and society as a whole. Several medications are indicated for the acute treatment of mania and depression associated with bipolar disorder as well as for maint...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11594930-000000000-00000
更新日期:2012-06-01 00:00:00