Abstract:
BACKGROUND:Cost-effectiveness analyses worldwide assume that the price of any single drug increases with inflation. New guidance from the Pharmaceutical Management Agency in New Zealand suggests that, when it is known that a generic drug will be available in the near future, a best estimate of the lower price of the generic should be included in the base-case cost-effectiveness analysis. Furthermore, in the sensitivity analysis, the real prices of the new and comparator drugs should be deflated by 2% per year as a proxy for inflation. OBJECTIVE:To challenge the widespread assumption that the price of any single drug increases with inflation in the UK, and to calculate the impact on the incremental cost-effectiveness ratio (ICER) of using a more realistic estimate for the future price of individual drugs. METHODS:The change in the real price of 373 drugs in the UK over the period 1980-2006 was calculated. Only those drugs launched after 1984 and with more than 500 prescriptions per year were analysed. A linear model of the change in real price by drug was fitted as a function of launch year, number of prescriptions, and British National Formulary (BNF) section. RESULTS:The mean annual decrease in the real price of individual drugs was 3.8% (95% CI 3.4, 4.2), with a standard deviation of 2.5%. Using this value, drugs would generally appear more cost effective than as presently calculated, i.e. the ICER would generally fall. The ICER would fall substantially for drugs for chronic conditions, e.g. by 15%, from 61,900 to 52,700 pound per QALY (year 2004 values) for cinacalcet for hyperparathyroidism. It is predicted that the ratio would fall even more for longer-term conditions such as multiple sclerosis. CONCLUSIONS:Most of the drugs previously appraised by the National Institute for Health and Clinical Excellence (NICE) are actually more cost effective than stated by NICE. Furthermore, most or all drugs for chronic conditions are actually far more cost effective than stated by NICE. Hence, it is likely that some of the previous negative decisions made by NICE concerning drugs for chronic conditions would instead have been positive if the methodology in this study had been implemented. It is recommended that, to capture the true cost of a drug, UK-based cost-effectiveness analyses should assume that the future real cost of a drug decreases over time, typically by 4% per annum, with a standard deviation of 2.5%. This change is very easy to implement in cost-effectiveness analyses. Similar conclusions may apply worldwide.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Hoyle Mdoi
10.2165/00019053-200826070-00006subject
Has Abstractpub_date
2008-01-01 00:00:00pages
589-602issue
7eissn
1170-7690issn
1179-2027pii
2676journal_volume
26pub_type
杂志文章abstract::Variable compliance with prescribed drug regimens is a leading source of variability in drug response. Specifics differ by drug and disease. The role of variable compliance was clearly defined in 2 trials of lipid-lowering agents, cholestyramine and gemfibrozil, in which exceptionally careful measurements of complianc...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199915030-00002
更新日期:1999-03-01 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:BACKGROUND AND OBJECTIVE:Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-012-0015-4
更新日期:2013-02-01 00:00:00
abstract::In this paper we consider the evolving American healthcare landscape and what it means for the use of economic evaluation of health interventions. We emphasise that use of economic evaluation in the US is unlikely to follow the European, Canadian or Australian models, which use cost effectiveness openly and explicitly...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624110-00012
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Glycoprotein (GP) IIb/IIIa receptor inhibitors enhance thrombolysis in patients with acute coronary syndromes. This analysis evaluates the economic impact of abciximab, a GP IIb/IIIa inhibitor, as an adjunct to urokinase in peripheral artery occlusions of less than 6 weeks duration. STUDY DESI...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200220030-00006
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of using different cost-effectiveness measures in the economic evaluation of cholesterol-modifying pharmacotherapy. DESIGN AND SETTING:An economic model was used to examine the extent to which the relative cost effectiveness of cholesterol-modifying agents varies depending upon the cos...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199916020-00008
更新日期:1999-08-01 00:00:00
abstract::We have defined the effect and acceptability of a locally developed general practice programme for the modification of prescribing. This voluntary programme consisted of prescription analysis and feedback, followed by visits from a pharmacist, a therapeutic bulletin on benzodiazepine prescribing, and use of a locally ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199507060-00009
更新日期:1995-06-01 00:00:00
abstract::In this article, we model the behavior of a pharmaceutical firm that has marketing authorization for a new therapy believed to be a candidate for personalized use in a subset of patients, but that lacks information as to why a response is seen only in some patients. We characterize the optimal outcome-based reimbursem...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0619-4
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Economic evaluations of new diabetes therapies rely heavily upon the UK Prospective Diabetes Study (UKPDS) equations for prediction of cardiovascular events; however, concerns persist regarding their relevance to current clinical practice and appropriate use in populations other than newly diagnosed patients....
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-014-0225-z
更新日期:2015-02-01 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::Increasingly in the developed world, patients expect to be partners in the management of their healthcare. Several recent studies show that the patient perspective differs from the perspective of the healthcare provider. Patients usually focus on the impact of their condition on their lifestyle, while clinicians may t...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200119002-00009
更新日期:2001-01-01 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: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::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::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::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 crite...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624090-00003
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Schizophrenia is a devastating and costly illness that affects 1% of the population in the US. Effective pharmacological therapies are available but suboptimal patient adherence to either acute or long-term therapeutic regimens reduces their effectiveness. The availability of a long-acting injection (LAI) fo...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523030-00009
更新日期:2005-01-01 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: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::Health economic evaluation is a framework for the comparative analysis of the incremental health gains and costs associated with competing decision alternatives. The process of developing health economic models is usually complex, financially expensive and time-consuming. For these reasons, model development is someti...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-017-0553-x
更新日期:2017-11-01 00:00:00
abstract::As part of the National Institute for Health and Care Excellence's (NICE) Single Technology Appraisal (STA) process, ruxolitinib was assessed to determine the clinical and cost effectiveness of its use in the treatment of disease-related splenomegaly or symptoms in adults with myelofibrosis. Ruxolitinib had previously...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-016-0447-3
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:In the past decade, the range of contraceptives available has increased dramatically. There are limited data on the factors that determine women's choices on contraceptive alternatives or what factors providers consider most important when recommending contraceptive products to women. OBJECTIVES:Our objecti...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11598040-000000000-00000
更新日期:2012-12-01 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::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::Weight Reduction is Cost-Effective for the Treatment of Non-alcoholic Fatty Liver Disease in Thailand. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-018-0754-y
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Healthcare resource use data were collected for 1 year as part of the CAESAR (Canada, Australia, Europe, South Africa) clinical trial, which evaluated the effect of adding lamivudine to treatment regimens containing zidovudine in patients with HIV infection. This study showed that lamivudine-containing regim...
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:10.2165/00019053-199915001-00003
更新日期:1999-01-01 00:00:00
abstract::The purpose of this study was to estimate the direct and indirect costs of alcoholism in the Federal Republic of Germany. Direct costs comprised treatment costs, while indirect costs consisted mainly of costs incurred as a result of work time lost, as well as costs related to premature retirement and premature mortali...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610050-00006
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Given the limited availability of healthcare resources and the recent introduction of new anti-osteoporosis drugs, the interest in the cost effectiveness of drugs in postmenopausal osteoporosis remains and even increases. OBJECTIVE:This study aims to identify all recent economic evaluations on drugs for pos...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0231-1
更新日期:2015-03-01 00:00:00
abstract:AIM:To determine the economic impact (cost-benefit analysis) of childhood varicella vaccination, with the Oka/Merck varicella zoster virus vaccine live (Varivax) in Italy. METHODS:This analysis is based on an epidemiological model of varicella zoster virus (VZV) dynamics adapted to the Italian situation. Cost data (Eu...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422130-00003
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To explore whether the National Institute for Health and Clinical Excellence (NICE) takes account of concerns other than just incremental cost effectiveness in commissioning healthcare services. METHOD:A stated preference binary choice experiment was used to explore the preferences of members of NICE's Appra...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725080-00006
更新日期:2007-01-01 00:00:00