Abstract:
BACKGROUND:In many healthcare systems, affordability concerns can lead to restrictions on the use of expensive efficacious therapies. However, there does not appear to be any consensus as to the terminology used to describe affordability, or the thresholds used to determine whether new drugs are affordable. OBJECTIVES:The aim of this systematic review was to investigate how affordability is defined and measured in healthcare. METHODS:MEDLINE, EMBASE and EconLit databases (2005-July 2016) were searched using terms covering affordability and budget impact, combined with definitions, thresholds and restrictions, to identify articles describing a definition of affordability with respect to new medicines. Additional definitions were identified through citation searching, and through manual searches of European health technology assessment body websites. RESULTS:In total, 27 definitions were included in the review. Of these, five definitions described affordability in terms of the value of a product; seven considered affordability within the context of healthcare system budgets; and 15 addressed whether products are affordable in a given country based on economic factors. However, there was little in the literature to indicate that the price of medicines is considered alongside both their value to individual patients and their budget impact at a population level. CONCLUSIONS:Current methods of assessing affordability in healthcare may be limited by their focus on budget impact. A more effective approach may involve a broader perspective than is currently described in the literature, to consider the long-term benefits of a therapy and cost savings elsewhere in the healthcare system, as well as cooperation between healthcare payers and the pharmaceutical industry to develop financing models that support sustainability as well as innovation.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Antoñanzas F,Terkola R,Overton PM,Shalet N,Postma Mdoi
10.1007/s40273-017-0514-4subject
Has Abstractpub_date
2017-08-01 00:00:00pages
777-791issue
8eissn
1170-7690issn
1179-2027pii
10.1007/s40273-017-0514-4journal_volume
35pub_type
杂志文章,评审abstract::The objective of this study was to demonstrate the cost effectiveness of long term maintenance treatment with citalopram versus standard therapy (defined as short term antidepressant treatment) in patients with major depression in Germany. We chose doxepin, amitriptyline and trimipramine as standard therapy because th...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199508020-00007
更新日期:1995-08-01 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
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND:Before the new round of healthcare reform in China, primary healthcare providers could obtain a fixed 15 % or greater mark-up of profits by prescribing and selling medicines. There were concerns that this perverse incentive was a key cause of irrational medicine use. China's new Essential Medicines Program (...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-013-0068-z
更新日期:2014-03-01 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::As part of its single technology process, the National Institute for Health and Care Excellence (NICE) invited the manufacturers of aripiprazole (Otsuka Pharmaceutical Co. and Bristol Myers Squibb) to submit evidence of the clinical and cost effectiveness of aripiprazole for the treatment and prevention of acute manic...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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journal_title:PharmacoEconomics
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doi:10.1007/s40273-017-0584-3
更新日期:2018-03-01 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::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
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journal_title:PharmacoEconomics
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journal_title:PharmacoEconomics
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更新日期:1997-04-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199712020-00016
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Head and neck cancer (HNC) and its treatment can affect communication, nutrition, and physical appearance, and the global impact of this disease on patients' quality of life may be substantial. OBJECTIVE:The aim of this systematic literature review was to describe the impact of HNC and its treatment on the ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2014-12-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-200422003-00003
更新日期:2004-01-01 00:00:00
abstract::Barrett's oesophagus is a premalignant complication that occurs in approximately 10% of patients with gastro-oesophageal reflux disease (GORD). In patients with Barrett's oesophagus, the risk of adenocarcinoma of the oesophagus approaches 0.5% per patient-years. Therefore, practice guidelines have been developed that ...
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725060-00001
更新日期:2007-01-01 00:00:00
abstract::In the current climate of cost containment and quality control, nosocomial infection is a worrisome adverse event in hospital care. Hospitalised patients require care for increasingly severe illnesses, and are therefore more susceptible to infection, especially by opportunistic micro-organisms. It is thus necessary to...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199507020-00005
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVES:Patients with chronic kidney disease (CKD) are commonly treated with renin-angiotensin-aldosterone system inhibitors (RAASi) in order to delay progression of renal disease. However, research has shown that RAASi in CKD patients increases hyperkalaemia (HK) prevalence, which leads to RAASi discontinuation or ...
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doi:10.1007/s40273-020-00902-w
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journal_title:PharmacoEconomics
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更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:To estimate the annual direct cost of managing erectile dysfunction (ED) to the UK National Health Service (NHS) and to examine the impact of the introduction of sildenafil in 1998 and Schedule 11 restrictions in 1999. DESIGN:A prevalence-based cost-of-illness approach was used. The period 1997 to 2000 was c...
journal_title:PharmacoEconomics
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doi:10.2165/00019053-200220130-00002
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doi:10.2165/11589270-000000000-00000
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journal_title:PharmacoEconomics
pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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更新日期:2019-09-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2002-01-01 00:00:00
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journal_title:PharmacoEconomics
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更新日期:1998-01-01 00:00:00
abstract::Total hip and knee replacements (THR and TKR) are high-risk settings for venous thromboembolism (VTE). This review summarizes the cost effectiveness of VTE prophylaxis regimens for THR and TKR. We searched MEDLINE (January 1997 to October 2009), EMBASE (January 1997 to June 2009) and the UK NHS Economic Evaluation Dat...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2010-01-01 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...
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pub_type: 杂志文章,评审
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更新日期:2011-04-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
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更新日期:2004-01-01 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
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更新日期:1992-07-01 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