Abstract:
:This paper analyses the 32 technology appraisals completed by the National Institute for Clinical Excellence (NICE) in the UK from its establishment to the end of January 2002. It looks at why technologies have been rejected, what has happened to products reviewed at launch, evidence of rationing on cost-effectiveness grounds, and the issues raised for manufacturers and for NICE in the collection and analysis of economic data. It finds that around two-thirds of NICE appraisals have been of pharmaceuticals. Only two 'first in class' products have been reviewed at launch, with quite different results. There is clear evidence of the use of cost-effectiveness criteria to restrict or reject technologies, although these are not the only criteria used in decision making. While a number of concerns with the appraisal process raised by manufacturers have been addressed by NICE, and while the Department of Health is currently consulting on changes to the referral system whereby products are selected for review by NICE, manufacturers remain concerned about the timing of referrals in the product life cycle and about the quality and consistency of the reviews of evidence undertaken by academic groups for NICE. Concerns in the National Health Service centre on whether the right technologies are being referred to NICE and also on the opportunity cost of positive NICE recommendations. Given global budget constraints and the difficulty of withdrawing services, the NICE recommendations tend to preempt growth money that could be used for more cost-effective purposes. NICE should be asked to look at established technologies that may not be cost effective and whose discontinuance could therefore release resources for other more cost-effective treatments.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Towse A,Pritchard Cdoi
10.2165/00019053-200220003-00010subject
Has Abstractpub_date
2002-01-01 00:00:00pages
95-105eissn
1170-7690issn
1179-2027pii
200010journal_volume
20 Suppl 3pub_type
杂志文章abstract::A systematic review of dementia cost-of-illness (COI) studies in the US and Canada was conducted to explore the policy-making relevance of these studies. MEDLINE, CINAHL, EconLit, AMED and the Cochrane Library were searched from inception to March 2010 for English-language COI articles. Content analysis was used to ex...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11539450-000000000-00000
更新日期:2011-02-01 00:00:00
abstract::Recombinant human erythropoietin (rHuEpo) has been increasingly used in preterm infants in the last 3 to 4 years. Recent studies have indicated a reduction in blood transfusion requirements in infants receiving rHuEpo. No significant adverse effects have emerged, apart from iron deficiency (if iron supplementation is ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199712040-00002
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine the costs and effects associated with a community pharmacy-based smoking-cessation programme in Northern Ireland, using the perspective of the payer in the main analysis. DESIGN AND SETTING:Data from a pilot study conducted in 2 community pharmacies in Northern Ireland w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814030-00008
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To compare the cost effectiveness of sequential intravenous (i.v.) to oral ciprofloxacin plus metronidazole (CIP/MTZ i.v./PO) with that of i.v. ciprofloxacin plus i.v. metronidazole (CIP/MTZ i.v.) and i.v. imipenem-cilastatin (IMI i.v.) in patients with intra-abdominal infections. DESIGN AND PARTICIPANTS:Pat...
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:10.2165/00019053-199916050-00011
更新日期:1999-11-01 00:00:00
abstract::A number of health-related QOL (HR-QOL) measures specifically designed for people with diabetes mellitus have appeared in the literature. This article provides a selective review of 12 measures that address this important construct. For each included study, a description of the measure and its development phase is pro...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422170-00002
更新日期:2004-01-01 00:00:00
abstract::This study evaluated the cost of sequential treatment with once-daily ofloxacin or twice-daily ciprofloxacin in 474 hospitalised patients in different countries. The patients were treated intravenously for at least 3 days, then orally for 7 to 10 days or for 3 days beyond the disappearance of infection-related symptom...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199711040-00007
更新日期:1997-04-01 00:00:00
abstract::Cost-effectiveness analysis (CEA) is one of the main tools of economic evaluation. Every CEA is based on a number of assumptions, some of which may not be accurate, introducing uncertainty. Sensitivity analysis (SA) formalizes ways to measure and evaluate this uncertainty. Specific sources of uncertainty in CEA have b...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11584630-000000000-00000
更新日期:2011-04-01 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:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease associated with increasing morbidity and mortality and an economic burden that stretches beyond the patient to healthcare systems. Avoiding exacerbations and subsequent hospitalizations is an important clinical aim and ca...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11590380-000000000-00000
更新日期:2011-05-01 00:00:00
abstract::Our objective was to assess the quality of reporting of original economic research articles in PharmacoEconomics from inception to the end of 1995, in order to identify areas of strength and weakness, and analyse trends over time. Each regular issue of the journal was examined for original economic evaluations. Accept...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199712060-00008
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:This study provides the results of a cost-effectiveness analysis of levetiracetam as an adjunctive treatment for refractory epilepsy from the Canadian Ministry of Health perspective. The main objective is to estimate the expected cost-effectiveness ratio expressed as the incremental cost per seizure-free day...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523050-00008
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:There are few empirical studies on the valuation of health profiles that describe the short-term fluctuations of chronic diseases. OBJECTIVE:This study aimed to value chronic obstructive pulmonary disease (COPD) health profiles, which describe the health of these patients over the course of 1 year from a so...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200927060-00003
更新日期:2009-01-01 00:00:00
abstract::Economic analysis of healthcare interventions is increasingly reliant on decision models to estimate the long-term costs and benefits of new therapies. Models permit analysts to take short-term clinical data to forecast long-term costs and benefits. Models should follow certain basic principles and can be appraised in...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200220001-00002
更新日期:2002-01-01 00:00:00
abstract::In this review, the economic aspects of pneumococcal pneumonia are analysed, including the costs, cost effectiveness and cost benefit of treatment and prevention. We identified eight cost-of-illness studies, 15 analyses comparing the costs of different treatment options and 15 economic evaluations of prevention that m...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422110-00003
更新日期:2004-01-01 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::The use of pharmacoeconomic tools has grown dramatically in the past decade as provision of healthcare throughout the industrialised world has required increased cost consciousness. However, pharmacoeconomic analysis has not yet been fully exploited as a conceptual underpinning for public or private health policy deci...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199916050-00001
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0734-2
更新日期:2019-02-01 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::A survey of the prescribing of psychotropic drugs was carried out at the Psychiatric Hospital of Bahrain. This retrospective study on 60 inpatients of the Long Stay Ward revealed a man:woman ratio of 2.7. 91% of the men and 88% of the women were over 40 years old. 44 of the 60 patients had a diagnosis of schizophre...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199201030-00007
更新日期:1992-03-01 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::Migraine headache is responsible for significantly more healthcare resource and lost labour costs than previously reported. Costs associated with migraine were assessed via a survey conducted in 940 patients, 70% of whom responded. All met the International Headache Society's diagnostic criteria for migraine and had ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199202010-00008
更新日期:1992-07-01 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:BACKGROUND:The use of granulocyte colony-stimulating factor (G-CSF) can enable dose intensification of chemotherapy in small-cell lung cancer (SCLC). However, given its acquisition cost, it is important to assess its cost effectiveness within a resource-constrained health service. OBJECTIVE:To assess the cost effectiv...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624050-00003
更新日期:2006-01-01 00:00:00
abstract:AIM:To estimate the direct and indirect costs of morbidity and mortality attributable to alcohol consumption in Germany from a societal perspective in 2002. METHODS:Using the concept of attributable risks and the prevalence-based approach, age- and gender-specific alcohol-attributable fractions for morbidity and morta...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725070-00006
更新日期:2007-01-01 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::Uncertainty in the decision-making process for reimbursement of health technologies could be reduced if additional information were available. Although methods to evaluate the monetary value of the uncertainty have been previously described, an economic evaluation of alternative methods to acquire additional informati...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200725110-00002
更新日期:2007-01-01 00:00:00
abstract::The original article can be found online. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-020-00950-2
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Candidaemia and other forms of invasive candidiasis (C/IC) are serious and costly events for hospitalized patients, particularly those in the ICU. Both fluconazole and the echinocandins are recommended as first-line therapy for C/IC. Resource use and cost considerations are important in selecting appropriate...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11584810-000000000-00000
更新日期:2011-08-01 00:00:00
abstract::Germany is in a period of transition with regard to healthcare reform. The number and intensity of cost control interventions increased during the last decade in an attempt to contain healthcare expenditure. The German legislature has implemented long term macroeconomic measures such as contribution rate stability and...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199600102-00013
更新日期:1996-01-01 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