Economic evaluation of pharmacologic therapy

Cost-benefit and cost-effectiveness analyses are defined and described, particularly as they apply to evaluating costs in pharmacologic therapy. The cost-benefit analysis (CBA) approach is used to compare dissimilar alternatives, whereas the cost-effectiveness (CEA) approach compares similar alternatives with similar objectives. A CBA, for instance, will demonstrate the economic effects of a program and can thus be used as a tool to compare the outcomes of several programs. A CEA, on the other hand, can help determine which of several alternatives is the least costly in achieving a stated objective. A CEA approach was used to examine results of clinical trials with cefoxitin or piperacillin in 86 patients undergoing intraabdominal surgery at two institutions. Results of multivariate analysis showed that patients who had received piperacillin had significantly shorter hospital stays (1.59 days) than those who had received cefoxitin. Based on national average hospital per diem rates, piperacillin patients were said to have saved $680 compared with patients treated with cefoxitin. Moreover, piperacillin was less expensive than cefoxitin.