Abstract:
OBJECTIVE:To decompose drug spending in Sweden between the years 1990 and 2000. This paper updates a previous study, which looked at the period 1990-1995, by providing an additional 5 years of data (1995-2000) and extending the previous analysis in a number of ways. METHODS:The paper builds on the earlier work that showed that changes in drug spending could be decomposed into three components: price, quantity and a residual. The size of the residual is a measure of the impact of changes in drug treatment patterns on drug spending. The data set used in this paper was collected from Apoteket AB (The National Corporation of Swedish Pharmacies) and was based on comprehensive information (inpatients as well as outpatients) on drug deliveries from wholesalers to pharmacies. Data were obtained for aggregate drug spending (from 1990-2000) and for spending according to anatomical therapeutic chemical (ATC) classification system group. RESULTS:Real drug spending increased by 119% during the study period. The residual rose by 67% indicating the switch from cheaper to more innovative and expensive drug therapies was a major cost driver. Real drug spending would have increased by about 31% if there had been no changes in treatment patterns. The second driver of drug spending was the quantity of drugs consumed, which increased by 41%. The main reason for the larger quantity sold appears to be increases in the intensity of medication in terms of defined daily doses per patient, rather than a larger number of patients starting drug treatment. Real prices decreased during the 10-year study period. We found large differences between ATC groups in terms of spending growth. The ATC groups that have contributed the most to the increase in spending are: drugs that affect the CNS (N), the alimentary tract and metabolism (A) and the cardiovascular system (C), which are also the three largest groups in terms of sales. For all three groups, it was the residual that mainly drove costs. CONCLUSION:This study indicates very clearly that the main driving force behind the increase in drug costs in Sweden between 1990 and 2000 was the change in drug therapy from old to new and more innovative and expensive drug therapies. This shows the importance of carrying out economic evaluations of new more costly drugs in order to make an assessment of the social benefits of a switch from a cheaper to a more expensive drug.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Gerdtham UG,Lundin Ddoi
10.2165/00019053-200422010-00003subject
Has Abstractpub_date
2004-01-01 00:00:00pages
29-42issue
1eissn
1170-7690issn
1179-2027pii
2213journal_volume
22pub_type
杂志文章abstract::To review and critically evaluate published cost-utility analyses (CUAs) pertaining to pharmaceuticals for the past 3 decades. We examined data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), which contains detailed information on English-language CUAs and their ratios (in $US...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11312720-000000000-00000
更新日期:2009-01-01 00:00:00
abstract::For practical reasons, in order to carry out economic evaluations of collective decisions, total costs will generally be compared with total benefits; hence, individuals' willingness to pay (WTP) or quality-adjusted life-years (QALYs) have to be estimated at an aggregate level. So far, aggregation has usually been don...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119040-00001
更新日期:2001-01-01 00:00:00
abstract::Decision-analytic models play a key role in informing healthcare resource allocation decisions. However, there are ongoing concerns with the credibility of models. Modelling methods guidance can encourage good practice within model development, but its value is dependent on its ability to address the areas that modell...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0499-z
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The measurement and valuation of health-related quality of life for and by young people are increasingly important, yet research on the impact of study perspective and validity of preferences obtained from young populations remains limited. OBJECTIVE:The objective of this study was to evaluate the feasibili...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00884-9
更新日期:2020-05-01 00:00:00
abstract::Pharmacoeconomics identifies, measures, and compares the costs and consequences of pharmaceutical products and services. The cost effectiveness of a pharmacotherapy in a particular indication depends on the molecular configuration of the drug, its safety and efficacy, and local market factors such as the acquisition ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199406040-00002
更新日期:1994-10-01 00:00:00
abstract::Epidural analgesia and intravenous analgesia with opioids are two techniques for providing pain relief for women in labour. Labour pain is comparable to surgical pain in its severity, and epidural analgesia provides better relief from this pain than intravenous analgesia; a meta-analysis quantified this improvement to...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200220050-00002
更新日期:2002-01-01 00:00:00
abstract::Darunavir boosted by low-dose ritonavir (DRV/r), at a daily dose of 600/100 mg twice a day (bid), has been shown to be superior to alternative highly active antiretroviral therapy (HAART) regimens for the management of treatment-experienced, HIV-infected adults in the phase IIb POWER trials and the phase III TITAN tri...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11587410-000000000-00000
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:The objective of this article was to summarize the findings of all the available studies on alternative pharmacological treatments for asthma and assess their methodological quality, as well as to identify the main drivers of the cost effectiveness of pharmacological treatments for the disease. METHODS:A sys...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0668-8
更新日期:2018-10-01 00:00:00
abstract::Constipation is one of the most common digestive complaints. It is a symptom, not a disease. The subjectivity that this involves means that assessments of clinical epidemiology, socioeconomic costs and pharmacotherapy are difficult, since there is no definition of 'normal' bowel habit. Although constipation can affect...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199507010-00003
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The ARTEMIS trial compared first-line antiretroviral therapy (ART) with lopinavir/ritonavir (LPV/r) to darunavir plus ritonavir (DRV + RTV) for HIV-1-infected subjects. In order to fully assess the implications of this study, economic modelling extrapolating over a longer term is required. OBJECTIVE:The aim...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-013-0048-3
更新日期:2013-05-01 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:BACKGROUND AND OBJECTIVE:Intensive insulin therapy improves glycosylated haemoglobin (Hb(A1C)) levels and delays the onset of long-term diabetes-related complications. Current treatment guidelines recommend maintaining a glycosylated haemoglobin (Hb(A1C)) of < or = 7% in patients with type 1 and 2 diabetes mellitus. Ho...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725030-00007
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:To reach the French market, a new drug requires a marketing authorization (MA) and price and reimbursement agreements. These hurdles could delay access to new and promising drugs. Since 1992, French law authorizes the use of unlicensed drugs on an exceptional and temporary basis through a compassionate-use p...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-013-0039-4
更新日期:2013-04-01 00:00:00
abstract::In today's environment, the demand for efficient healthcare resource allocation is increasing. As new technologies become available, allocation decisions become more complex and tools to assist decision makers in determining efficient allocations of healthcare resources are encouraged. Mathematical programs have multi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200321120-00001
更新日期:2003-01-01 00:00:00
abstract::Answering the demanding questions asked of pharmacotherapy in the 21st century will require more reliance on the disciplines of pharmacoepidemiology and pharmacoeconomics. Pharmacoepidemiology can help assess patterns and appropriateness of drug utilisation, provide explanations for poor compliance, quantify the frequ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422002-00009
更新日期:2004-01-01 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::This century has seen a phenomenal growth in the development, understanding and use of pharmaceuticals. Additionally, this period has seen the balance of the treatment needs of patients shift dramatically from infectious to cardiovascular and cancer diseases, and from infancy and middle-age to old age. The value of mo...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813060-00001
更新日期:1998-06-01 00:00:00
abstract::Productivity costs are frequently omitted from economic evaluations, despite their often strong impact on cost-effectiveness outcomes. This neglect may be partly explained by the lack of standardization regarding the methodology of estimating productivity costs. This paper aims to contribute to standardization of prod...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-014-0132-3
更新日期:2014-04-01 00:00:00
abstract::Published estimates for the treatment costs of breast cancer vary widely in methodology, perspective, patient populations and time horizon. We systematically summarized and analysed the published literature on per-patient costs of breast cancer, and highlight the perspectives, populations studied, time horizons and fu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/00019053-200927030-00003
更新日期:2009-01-01 00:00:00
abstract::Multiple sclerosis (MS) is a disease of the CNS, typically striking adults during the primary productive time of their life. The symptoms of MS can restrict the individual's physical activity and income-earning ability, resulting in a major financial burden on the patient, family, health system and society. This syste...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/11532230-000000000-00000
更新日期:2010-01-01 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: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: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:BACKGROUND:The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adher...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0554-9
更新日期:2017-12-01 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::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::Drug utilisation in term and preterm neonates (i.e. less than 28 days of age) has been investigated prospectively in 4 clinical studies during the past 10 years. 3880 neonates with a mean gestational age of 34.5 weeks (corresponding birthweight 2280g) were enrolled in these studies. An overview indicates a high prev...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199304060-00005
更新日期:1993-12-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to evaluate the potential economic implications of using etoricoxib versus non-selective NSAID alternatives in the treatment of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) in the UK. STUDY DESIGN:Decision-analytical modelling was used to calculate the exp...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422100-00003
更新日期:2004-01-01 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::An increasing number of ACE inhibitors have become available in recent years. Because these agents are all similar, careful scrutiny is required in order to determine specific advantages of particular agents when making formulary decisions. Differences between agents with regard to structure and tissue specificity hav...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199610060-00006
更新日期:1996-12-01 00:00:00