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Economic evaluation of new therapies in critical illness
Michael T Coughlin1, Derek C Angus
1Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract:
The recent Food and Drug Administration approval of drotrecogin alfa (activated) and the potential of several other new therapies may represent the beginning of a breakthrough in the management of critical illness in the intensive care unit. However, their use in clinical practice will likely be dependent on a rigorous appraisal not only of their effects, but also of their costs. Novel therapies can no longer be judged simply by their effectiveness in treating illness, but must also be evaluated on an institutional and societal level on the basis of their cost. These considerations have important implications for the practicing intensivist, who will need to better understand the conduct and design of economic evaluations, including their strengths and weaknesses. In this article, we review the rationale behind economic evaluations of new therapies and the alternative economic approaches available. We then discuss in more detail the elements contained in a cost-effectiveness analysis, the preferred approach to pharmacoeconomic evaluation today.
Insights
New intensive care unit therapies require cost-effectiveness analysis alongside clinical effectiveness. Understanding economic evaluations is crucial for practicing intensivists to assess novel treatments like drotrecogin alfa (activated).
Area of Science:
- Critical care medicine
- Health economics
- Pharmacoeconomics
Background:
- Recent FDA approval of drotrecogin alfa (activated) signals potential breakthroughs in critical care.
- Novel therapies in intensive care units (ICUs) must be evaluated for both efficacy and cost.
- Clinical practice adoption of new treatments depends on rigorous cost-benefit appraisals.
Purpose of the Study:
- To review the rationale for economic evaluations of new ICU therapies.
- To explore alternative economic approaches for evaluating novel treatments.
- To detail the components of cost-effectiveness analysis (CEA) in pharmacoeconomics.
Main Methods:
- Review of economic evaluation principles.
- Discussion of various economic assessment methodologies.
- In-depth examination of cost-effectiveness analysis framework.
Main Results:
- Economic evaluations are essential for appraising new therapies beyond mere effectiveness.
- Cost-effectiveness analysis is the preferred method for pharmacoeconomic evaluation.
- Practicing intensivists need to understand the design and interpretation of economic studies.
Conclusions:
- The integration of economic evaluations is vital for the successful implementation of novel ICU therapies.
- Pharmacoeconomic assessments, particularly CEA, guide institutional and societal decision-making.
- Enhanced understanding of economic evaluations empowers intensivists in clinical practice.