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Related Experiment Videos

Using economic evaluations to make formulary coverage decisions. So much for guidelines.

A H Anis1, Y Gagnon

  • 1Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada. anis@cheos.ubc.ca

Pharmacoeconomics
|September 30, 2000
PubMed
Summary

Most pharmacoeconomic analyses submitted for British Columbia

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Area of Science:

  • Health Economics
  • Pharmacoeconomics
  • Health Technology Assessment

Background:

  • Drug manufacturers must submit pharmacoeconomic analyses for formulary inclusion in British Columbia.
  • Submissions are reviewed by the Pharmacoeconomic Initiative (PI) of BC.

Purpose of the Study:

  • Assess compliance of submitted analyses with established guidelines.
  • Evaluate the methodological quality of individual submissions.
  • Demonstrate the impact of guideline compliance on decision-making.

Main Methods:

  • Reviewed 95 pharmacoeconomic submissions to the PI of BC (1996-1999).
  • Assessed compliance using a checklist covering comparator drug, perspective, sensitivity analysis, horizon, and discounting.
  • Examined associations between analysis type, author, compliance, and recommendation.

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Main Results:

  • 65 of 88 submissions (74%) failed to comply with guidelines.
  • Non-compliance was high for comparator choice (45%), sensitivity analysis (61%), perspective (73%), and long-term evaluation (66%).
  • Industry-conducted studies, particularly cost-comparison/consequence and budget-impact analyses, showed lower compliance and recommendation rates.

Conclusions:

  • Poor compliance with pharmacoeconomic guidelines was observed, especially in industry-sponsored studies.
  • Guideline compliance and analysis type significantly influence recommendations for drug formulary inclusion.
  • Improving adherence to guidelines is crucial for effective health technology assessment and decision-making.