Published Jan 2010
Citation
Hay JW, Smeeding J, Carroll NV, et al. Good research practices for measuring drug costs in cost effectiveness analyses: issues and recommendations: the ISPOR Drug Cost Task Force Report-part I. Value Health. 2010;13(1):3-7.
Abstract
Objectives: The assignment of prices or costs to pharmaceuticals can be
crucial to results and conclusions that are derived from pharmacoeconomic
cost effectiveness analyses (CEAs). Although numerous pharmacoeconomic
practice guidelines are available in the literature and have been
promulgated in many countries, these guidelines are either vague or silent
about how drug costs should be established or measured. This is particularly
problematic in pharmacoeconomic studies performed from the “societal”
perspective, because typically the measured cost of a brand name
pharmaceutical is not a true economic cost but also includes transfer
payments from some members of society (patients and third party payers)
to other members of society (pharmaceutical manufacturer stockholders)
in large part as a reward for biomedical innovation. Moreover, there are
numerous and complex institutional factors that influence how drug costs
should be measured from other CEA perspectives, both internationally
and within the domestic US context. The objective of this report is to
provide guidance and recommendations on how drug costs should be
measured for CEAs performed from a number of key analytic perspectives.
Methods: ISPOR Task Force on Good Research Practices—Use of Drug
Costs for Cost Effectiveness Analysis (Drug Cost Task Force [DCTF]) was
appointed with the advice and consent of the ISPOR Board of Directors.
Members were experienced developers or users of CEA models, worked in
academia, industry, and as advisors to governments, and came from
several countries. Because how drug costs should be measured for CEAs
depend on the perspectives, five Task Force subgroups were created to
develop drug cost standards from the societal, managed care, US government,
industry, and international perspective. The ISPOR Task Force on
Good Research Practices—Use of Drug Costs for Cost Effectiveness
Analysis (DCTF) subgroups met to develop core assumptions and an
outline before preparing six draft reports. They solicited comments on the
outline and drafts from a core group of 174 external reviewers and more
broadly from the membership of ISPOR at two ISPOR meetings and via
the ISPOR web site.
Results: Drug cost measurements should be fully transparent and reflect
the net payment most relevant to the user’s perspective. The Task Force
recommends that for CEAs of brand name drugs performed from a societal
perspective, either 1) CEA analysts use a cost that more accurately
reflects true societal drug costs (e.g., 20–60% of average sales price), or
when that is too unrealistic to be meaningful for decision-makers, 2) refer
to their analyses as from a “limited societal perspective.” CEAs performed
from a payer perspective should use drug prices actually paid by the
relevant payer net of all rebates, copays, or other adjustments. When such
price adjustments are confidential, the analyst should apply a typical or
average discount that preserves this confidentiality.
Conclusions: Drug transaction prices not only ration current use of medication
but also ration future biomedical research and development. CEA
researchers should tailor the appropriate measure of drug costs to the
analytic perspective, maintain clarity and transparency on drug cost measurement,
and report the sensitivity of CEA results to reasonable drug cost
measurement alternatives.
Keywords: cost effectiveness analysis, drug costs, drug research and development,
health-care market segmentation, health-care reimbursement,
payer perspective.
Full Content
Log In to View ReportRelated Content
Reports
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: An International Perspective - ISPOR drug cost task force report - Part VI
- Good Research Practices for Measuring Drug Costs in Cost Effectiveness Analyses: An Industry Perspective - ISPOR drug cost task force report - Part V
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: Medicare, Medicaid and US Government Payers Perspectives ISPOR drug cost task force report - Part IV
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: A Managed Care Perspective - ISPOR drug cost task force report - Part III
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: A Societal Perspective - ISPOR drug cost task force report - Part II
Questions?
For any questions about this report please contact us.