Cost-effectiveness of therapeutic drug monitoring

Cost effectiveness analysis (CEA) has been applied to a wide range of health care procedures including TDM. The need for CEA of TDM has resulted from economic pressures for cost justification exerted by hospital administrators, government and, in the United States, by third party health insurers. The lack of well-designed studies has made it difficult to prove (or disprove) the credibility of TDM on an economic basis. When conducting a cost analysis evaluation of TDM, all costs and benefits must be identified, and to determine the program's viability, a study-specific analytical model is required. Ideally, the study should be controlled, comparative, prospective and have patient outcome as an assessed endpoint. Therapeutic drug monitoring has been shown to be cost-effective when SDCs are used with a sound pharmacokinetic basis, when the drugs monitored show a strong correlation between serum concentration and therapeutic outcome, and when the program has been well accepted by the professional personnel within the institution.