Reassessing the relevance of pharmacoeconomic analyses in formulary decisions

A Systematic Review on the Extent and Quality of Pharmacoeconomic Publications in Egypt

BACKGROUND

Egypt faces many challenges when matching patient needs with available resources. Consequently, there has been an increasing interest in pharmacoeconomics as an aid tool in health decision-making to better allocate resources.

OBJECTIVES

To review and evaluate the volume and the quality of published pharmacoeconomic studies in Egypt.

METHODS

A literature search was conducted in August 2018 using PubMed, Google Scholar, and Cochrane library to identify published Egyptian pharmacoeconomic studies. Articles were included if they were original economic studies, written and published in English, and conducted in Egypt. Each article was assessed independently by two reviewers using the 100-point Quality of Health Evaluation Studies (QHES) scale.

RESULTS

Fifteen studies published between 2002 and 2017 were included in the review. Most of them were cost-effectiveness analyses (60%). The minority used secondary data (33.3%) or adopted modeling techniques (40%). The mean QHES score of the included studies was 70.1 ± 21.8, and approximately 40% of them had a QHES score of more than 80.

CONCLUSION

Pharmacoeconomic evaluations in Egypt are still in their infancy. The Egyptian guidelines for economic evaluation should be adopted and the EQ-5D-5L value sets should be developed to increase the quality of economic research.

Multi-Party, Multi-Sector Knowledge Creation: Maximising Outcomes Through Stakeholder Collaboration

This paper illustrates an example of successful collaboration amongst a number of organisations within the "Triple Helix" of government-industry-university relations whose mandate is to create, share and disseminate knowledge. A stakeholder perspective is used to identify a number of conditions that are suggested as being necessary for such complex collaborations to achieve their desired outcomes.

Use of health-related quality of life information in managed care formulary decision-making

BACKGROUND

The extent to which the increased volume of available health-related quality of life (HRQOL) information and heightened education has increased the acceptance and use of HRQOL remains unclear. Likewise, the value of HRQOL information in the formulary decision-making process continues to be undefined.

OBJECTIVE

To investigate the perceptions and use of HRQOL by managed care decision-makers in the formulary development process.

METHODS

A mail survey was sent to a nationwide sample of 108 Academy of Managed Care Pharmacy (AMCP) members who were involved in formulary management. Survey candidates were identified according to their job titles listed in the 1999-2000 AMCP membership directory. The survey process began in May 2000 and ended in August 2000. The main outcome measures included (a) managed care formulary decision-makers' assessment of HRQOL as a treatment outcome, (b) the existing role and future use of HRQOL information in formulary decisions, and (c) the level of understanding of HRQOL concepts and the benefits attributable to favorable HRQOL results.

RESULTS

A response rate of 51.9% was obtained. Most of the respondents (>70%) believed that patients consider HRQOL as an important treatment outcome. Fewer respondents (43%) felt that payers view HRQOL outcomes as an important quality indicator. Most respondents (95%) considered HRQOL data in making formulary decisions, and many (73%) believe that HRQOL outcomes will play a more important role in future formulary decisions. Respondents indicated a better understanding of disease-specific and generic HRQOL measurements than utility measurement and interpretation of results. A minority of respondents (34%) would be willing to pay a higher price for a product with better HRQOL outcomes. When asked which factors would lead to increased use of HRQOL information, respondents indicated that health care cost savings and increased productivity were considered important (77% and 65%, respectively).

CONCLUSIONS

A drug product with better HRQOL outcomes alone will not command a favorable listing on managed care formularies. HRQOL information needs to be made more applicable to managed care decision-making. Future studies should focus on the link between positive HRQOL outcomes, health care cost savings, and increased productivity.

Economics of antibiotic administration

This article examines several elements of antibiotic administration that make it worthy of policy analysis, including microbial resistance, contagion, competing brand and generic drugs, and formulary restrictions by insurers and hospitals. These topics are explored using two concepts from health economics, cost-effectiveness and externalities, revealing theoretical and empirical evidence that society may not be using antibiotics as efficiently as it could.