Published Jan 2010
Garrison Jr. LP, Mansley EC, Abbott III TA, et al. Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: A Societal Perspective: The ISPOR Drug Cost Task Force Report-Part II. Value Health 2010;13:8-13.
Objectives: Major guidelines regarding the application of costeffectiveness
analysis (CEA) have recommended the common and widespread
use of the “societal perspective” for purposes of consistency and
comparability. The objective of this Task Force subgroup report (one of six
reports from the International Society for Pharmacoeconomics and Outcomes
Research [ISPOR] Task Force on Good Research Practices—Use of
Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force
(DCTF)]) was to review the definition of this perspective, assess its specific
application in measuring drug costs, identify any limitations in theory or
practice, and make recommendations regarding potential improvements.
Methods: Key articles, books, and reports in the methodological literature
were reviewed, summarized, and integrated into a draft review and report.
This draft report was posted for review and comment by ISPOR membership.
Numerous comments and suggestions were received, and the report
was revised in response to them.
Results: The societal perspective can be defined by three conditions: 1) the
inclusion of time costs, 2) the use of opportunity costs, and 3) the use of
community preferences. In practice, very few, if any, published CEAs have
met all of these conditions, though many claim to have taken a societal
perspective. Branded drug costs have typically used actual acquisition cost
rather than the much lower social opportunity costs that would reflect
only short-run manufacturing and distribution costs. This practice is
understandable, pragmatic, and useful to current decision-makers. Nevertheless,
this use of CEA focuses on static rather than dynamic efficacy and
overlooks the related incentives for innovation.
Conclusions: Our key recommendation is that current CEA practice
acknowledge and embrace this limitation by adopting a new standard for
the reference case as one of a “limited societal” or “health systems”
perspective, using acquisition drug prices while including indirect costs
and community preferences. The field of pharmacoeconomics also needs
to acknowledge the limitations of this perspective when it comes to important
questions of research and development costs, and incentives for
Keywords: drug costs, dynamic efficiency, social costs, societal perspective.
Full ContentDownload PDF
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: A Managed Care Perspective
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: Medicare, Medicaid and Other US Government Payers Perspectives
- Good Research Practices for Measuring Drug Costs in Cost Effectiveness Analyses: An Industry Perspective
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: An International Perspective
- Good Research Practices for Measuring Drug Costs in Cost Effectiveness Analyses: Issues and Recommendations