Abstract:
:A number of recent findings from the literature imply that the value of a QALY varies depending on the concentration or dispersion of that QALY over treated individuals. Given that funding decisions are currently made under either the assumption of distributive-neutrality or some combination of explicit decision criteria and implicit adjustment for distributional concerns, it is likely that substantial social welfare gains are available if distributional objectives could be more accurately reflected in funding decisions. This paper considers three alternative approaches to explicitly adjust for distributional concerns with regard to the concentration or dispersion of individual health gains. Including non-health arguments in the objective function by 'weighting' QALYs for distributional effects or imposing differential funding thresholds for interventions with different distributional effects might be considered first- and second-best solutions, and would likely deliver the greatest social welfare gains. However, there is some doubt that first- or second-best solutions would be: (i) feasible given current data gaps; and (ii) politically acceptable. Rather, a simple and transparent approach is suggested wherein the sponsors of interventions that deliver health gains that are of questionable 'welfare-significance' for the treated individual would be required to provide decision-makers with an estimate of willingness to pay for the QALYs in question and would only be eligible for funding in the event that the positive net present value criterion is met.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Mortimer Ddoi
10.2165/00019053-200624090-00003subject
Has Abstractpub_date
2006-01-01 00:00:00pages
845-53issue
9eissn
1170-7690issn
1179-2027pii
2493journal_volume
24pub_type
杂志文章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::Cefotaxime is a parenterally administered third generation cephalosporin with a broad spectrum of antimicrobial activity. After more than a decade of use, cefotaxime continues to play an important role in the treatment of patients with serious infections, particularly those caused by Gram-negative bacteria. Clinical t...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199813010-00009
更新日期:1998-01-01 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::Pneumocystis carinii pneumonia (PCP) is the most common severe opportunistic infection, and one of the most costly, among people with AIDS. Over 50% of patients experience toxic effects of the major anti-PCP medications- cotrimoxazole (trimethoprim-sulfamethoxazole) and pentamidine. Recently, the US Food and Drug Admi...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199609060-00007
更新日期:1996-06-01 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: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::About half of the world's population live in Asia. Mandarin (the official language of China), Hindi and Japanese are among the ten languages spoken by the largest number of primary speakers. The numbers of Tamil and Malay speakers are expected to grow rapidly in the next few decades. Most health-related quality-of-lif...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624070-00003
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Carcinoid syndrome, a rare condition in patients with neuroendocrine tumours, characterised by flushing and diarrhoea, severely affects patients' quality of life. The current carcinoid syndrome standard of care includes somatostatin analogues, but some patients experience uncontrolled symptoms despite somato...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00896-5
更新日期:2020-06-01 00:00:00
abstract::The broad spectrum of antibacterial activity and favourable pharmacokinetic profile of ciprofloxacin permit oral treatment of many serious infections which have traditionally necessitated parenteral antibacterial therapy. This has been demonstrated in comparative studies, in which ciprofloxacin was as effective and w...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199303050-00007
更新日期:1993-05-01 00:00:00
abstract::In an attempt to obtain an appropriate estimate of the excess costs of production losses arising from morbidity in patients with diabetes, we compared the number of sick days and permanently disabled individuals in a diabetic population and the corresponding general population. These comparisons show that the rate of ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199500081-00007
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost effectiveness of dabrafenib versus dacarbazine and vemurafenib as first-line treatments in patients with BRAF V600 mutation-positive unresectable or metastatic melanoma from a Canadian healthcare system perspective. METHODS:A partitioned-survival analysis model with three mutually exclus...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-014-0241-z
更新日期:2015-04-01 00:00:00
abstract:UNLABELLED:Cyclosporin microemulsion (Neoral) is a self-emulsifying preconcentrate of cyclosporin which is more rapidly and consistently absorbed than the original oil-based formulation of cyclosporin (standard formulation; Sandimmun, Sandimmune). This superior pharmacokinetic profile suggests that cyclosporin microemu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199814060-00009
更新日期:1998-12-01 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:BACKGROUND:In Ireland, all new drugs are considered for a formal pharmacoeconomic evaluation (PE) prior to a reimbursement decision. All evaluations are conducted by the National Centre for Pharmacoeconomics (NCPE). The objectives of this study were to describe the evaluation process and to examine the movement of drug...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-016-0437-5
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:During the 1990s, a number of new cytotoxic agents with clinically relevant activity in non-small-cell lung cancer (NSCLC), and with a more favourable therapeutic index than drugs already in use, became available. Given the high prices of these new drugs and the large number of patients affected, it is impor...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523110-00007
更新日期:2005-01-01 00:00:00
abstract::This article explores the need to perform pharmacoeconomic evaluations of herbal medicines and assesses the extent to which this approach has been applied so far to these products. There seems to be no compelling need for pharmacoeconomic analyses of herbal over-the-counter medicines, but such analyses are certainly w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018010-00001
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Assessing the societal perspective in economic evaluations of new interventions requires estimates of indirect non-medical costs caused by the disease. Different methods exist for measuring the labor input function as a surrogate for these costs. They rarely specify the effect of health on labor and who gain...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00978-4
更新日期:2020-11-25 00:00:00
abstract::The aim of this article was to perform a detailed methodological review of models used to estimate the cost effectiveness of drug treatment regimens for HIV infection in Europe and North America and assess the relationship between the different modeling approaches or key structural assumptions and the results. Electro...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-013-0098-6
更新日期:2013-11-01 00:00:00
abstract::Deterministic sensitivity analyses (DSA) remain important to interpret the effect of uncertainties in individual parameters on results of cost-effectiveness analyses. Classic DSA methodologies may lead to wrong conclusions due to a lack of or misleading information regarding marginal effects, non-linearity, likelihood...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00979-3
更新日期:2021-01-01 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:BACKGROUND:International phase III studies (CHIB 201 and 352) showed that basiliximab, a high affinity chimeric monoclonal antibody interleukin-2 receptor antagonist, is highly effective in preventing acute rejection when used as immunoprophylaxis in patients receiving cyclosporin (Neoral). We conducted a cost evaluati...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200321110-00003
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Mapping Patient-Reported Outcomes Measurement Information System-Global Health (PROMIS-GH) to EuroQol 5-dimension, three-level version (EQ-5D-3L) provides a utility score for use in quality-of-life and cost-effectiveness analyses. In 2009, Revicki et al. mapped the PROMIS-GH items to EQ-5D-3L utilities using...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0541-1
更新日期:2017-11-01 00:00:00
abstract::The past few years have seen rapid changes in the methods of decision-analytic modelling of healthcare programmes for the purposes of economic evaluation. This paper focuses on four developments in modelling that have emerged over the past few years or have become more widely used. First, no one optimal method for ext...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624110-00002
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:The reliability and validity of generic utility measures have not yet been summarized in people with multiple sclerosis (MS). It is important to assess the psychometric properties of these measures, to ensure that the values obtained by the scoring system are valid for interpretation and utilization by clinic...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0167-5
更新日期:2014-08-01 00:00:00
abstract::The regulation of pricing and trade for in-patent medicines within the European pharmaceutical sector presents a major challenge. In conditions of large sunk costs and consumers with differential willingness to pay--between different Member States--an efficient way of pricing in-patent medicines is through price discr...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018001-00008
更新日期:2000-01-01 00:00:00
abstract::Whereas individual cost-effectiveness analyses of new agents for acute leukaemia should be performed in target populations, any meaningful pharmacoeconomic evaluation of treatment options for this condition should include the many types of costs and outcomes in unselected, representative groups of patients. Both direc...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199915020-00005
更新日期:1999-02-01 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::Randomized controlled trials provide unbiased estimates of treatment effect through reducing the attribution of observed differences in outcome to the play of chance or the treatment of interest. Issues in the design of randomized trials may lead to a dilution or magnification of treatment effect when compared with cl...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200927010-00002
更新日期:2009-01-01 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:OBJECTIVE:The objective of this study was to assess the cost effectiveness of using epoetin-alpha (erythropoietin) to augment preoperative autologous donation (PAD) of blood prior to elective cardiac surgery. DESIGN AND SETTING:We designed a decision-analytic model incorporating the risk of receiving allogeneic blood,...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018020-00006
更新日期:2000-08-01 00:00:00