Magazine article Drug Topics

Pharmacoeconomics: A Still-Fuzzy Buzzword

Magazine article Drug Topics

Pharmacoeconomics: A Still-Fuzzy Buzzword

Article excerpt

Pharmacoeconomics research may be one of the hottest new trends affecting managed care pharmacy, but even the experts acknowledge there's no agreement on just what it is and how it should be done.

That was the admission from Brian Dickson, who heads his own pharmacoeconomics research organization, Dickson Research Group/In Vivo, Princeton, N.J. He spoke as the chairman of a conference on pharmacoeconomics held in Philadelphia in mid-April, sponsored by the Institute for International Research.

Although he said there may be agreement that pharmacoeconomics has to do with assessing the relative cost-effectiveness of competing therapies, "there are no standards, no simple rules" for conducting pharmacoeconomic research. Nevertheless, the tongue twister of a term is headed in the direction of pharmacy's mainstream, deciding what goes on--or off--the formularies of managed care pharmacy plans.

Ultimately, pharmacoeconomics is something community pharmacists may have to explain to customers, who may want to know, for instance, why their health plan's formulary has dropped one antiulcer drug and replaced it with another. What makes one drug more cost-effective than another?

Because managed care organizations want to limit their formulary to a few drugs in most categories, the MCOs want to know which of the drugs in each category are the most cost-effective. Pharmacoeconomics research is supposed to answer just that question. But how?

Somehow each drug needs to be compared to other drugs in its category, with a look at not only the price, but at other factors that need to be measured, such as whether the drug causes side effects, how effective it is, how quickly it works, how easy it is to administer, and whether it is taken once or several times a day--a factor affecting compliance. How to measure and compare such factors is the subject of much debate. Each drug also has to be compared to any alternative nondrug therapies available to treat the same illness.

In the future, the Food & Drug Administration will inevitably call for pharmacoeconomic research to be included with the clinical trial data that are submitted for new drug approval applications, Dickson predicted. …

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