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Great Research or Lack of Training
Steve Marx MS, PharmD, BSc, ISPOR CONNECTIONS Editor-in-Chief and Director, Global Health Economics & Outcomes Research,
Abbott Labs, Abbott Park, IL, USA, Peter Wong PhD, RPh, MS, MBA, ISPOR CONNECTIONS Editorial Board Member and VP, Quality
& Clinical Effectiveness, Mercy Health Partners, Southwest Region, Cincinnati, OH, US, and Stephen Priori, Director of Publications,
ISPOR, Lawrenceville, NJ, USA
In an effort to bridge the understanding between
pharmacoeconomics & outcomes researchers
and decision makers, the ISPOR CONNECTIONS
Editorial Board surveyed our membership. A web
based survey was sent to all ISPOR members, of
which 122 responded. The aim for the survey is
to understand the degree of incorporation of
PEOR studies in decision making by decision
makers.
 Thirty-four percent (n = 42) of the respondents
identified themselves as a drug, medical device
or diagnostic treatment decision makers. Years of
experience as a decision maker were categorized
as: less than 1 year, 1-5yrs, 6-10yrs, 16-20 yrs,
and greater than 20 years. The majority of the
decision maker’s stated that years of experience
was 1 to 5 years, which declined until greater
than 20 years. Approximately a quarter of the
respondents were members of a Pharmacy &
Therapeutics Committees, and a fifth were practicing
pharmacists (Figure 1).
The majority of the respondents resided in the US
and other, followed by the United Kingdom,
Germany, Canada, and Japan. Most country’s
health care financing was government or private
insurance, employer; approximately 50% followed
by private insurance, individual and self
pay or out-of-pocket about 40%, the remainder
was 100% employee sponsored or other. Seventy
percent of the respondent’s reimbursement
authorities were national government or pharmacy
& therapeutics committee, 45% were direct
care providers, 30% were regional government,
27% regional insurance health plans, 25% national
insurance health plans, 20% patients, and 10%
other. Seventy-five percent of the respondents
had a pharmacy & therapeutics committee, 30%
had a technology assessment committee and
15% had another type of committee. 48% of the
respondents are members of the pharmacy &
therapeutics committee, 15% member of technology
assessment committee, and 15% other.
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All the decision makers have read articles that
have used pharmacoeconomics; the majority has
read articles related to other common terms
within pharmacoeconomics and outcomes
research. Overall, 95% of decision makers
answered “yes” to receiving formal training.
Ninety percent of the decision makers had some
training in pharmacoeconomics and as low as
40% had formal training related to burden of illness
and patient-reported outcomes (Figure 2).
The term training in this survey refers to “formal
schooling, attended courses, worked with an
expert or read extensively.”
Ninety-five percent of the decision makers
believed the training helped them in selecting the
appropriate drug, medical device, or diagnostic
treatment. Eighty-six percent of decision makers
used some type of pharmacoeconomic analysis
to make decisions. Cost-effectiveness analysis
and cost-minimization analysis were the most
common types of analysis used to make health
care decisions (Figure 3).
Seventy-nine percent of decision makers have
conducted some type of pharmacoeconomic analysis. Again, cost-effectiveness and
cost minimization analysis were the most common analyses preformed
(Figure 4).
Seventy-five percent of decision makers considered
pharmacoeconomic and/or outcomes
research in their last drug, medical device or diagnostic
treatment decision. Seventy-five percent of
decision makers routinely use pharmacoeconomic
and/or outcomes research to make medical
device or diagnostic treatment decisions.
Cost-effectiveness analysis provided them with
the best information to make their drug, medical
device, or diagnostic treatment decisions, and burden
of illness has the least usefulness. (Figure 5).
The majority of decision makers (66%) felt that
they were provided with totally inadequate or
somewhat inadequate pharmacoeconomic and
outcomes research information to make drug,
medical device, or diagnostic treatment decision
(Figure 6).Overall, it appears pharmacoeconomics and outcomes
research plays an important role in the
budgetary decision making. Many decision makers
have limited years of experience, and additional
formal training of some decision makers
may be desirable. Most decision makers feel that
the type of pharmacoeconomic and outcomes
research information is inadequate. It is unclear
whether the decision makers have the adequate
training to assess the information or the type of
information provided by researchers is inadequate
or both. Based on this small sample size
survey, there is an information gap between the
producers of the pharmacoeconomic and outcomes
research information and the users of the
information. Perhaps, a focus group study in the
future will identify means to bridge such gap. |
We plan on follow-up with specific countries to
better understand the importance and utilization
of pharmacoeconomic & outcomes research by
decision makers.
If you have any suggestions, please send them
to: isporconnections@ispor.org.
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