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IJRPC 2013, 3(1) Ankur Rohi l l a et al ISSN: 2231

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INTERNATIONAL JOURNAL OF RESEARCH IN PHARMACY AND CHEMISTRY

Available online at www.ijrpc.com

PHARMACOECONONICS: AN OVERVIEW

Ankur Rohi lla1*, Amit Kumar 1, Rahul Keshari1, Amarjeet Dahiya1, Gurfateh Singh2

and Ashok Kushnoor 1

1Department of Pharmaceutical Sciences, Shri Gopi Chand Group of Institutions,Baghpat-250609, Uttar Pradesh, India.

2Sachdeva College of Pharmacy, Gharuan, Kharar, Mohali, Punjab, India.

INTRODUCTIONEconomic evaluation has been regarded toprovide valuable information to healthcaredecision-makers that allow optimal allocation oflimited resource

1-2s. In addition, economic

studies are considered essential in order toadjust the amount expended for treatment, andhence, the crucial aim of analyzing economiesfor providing effective use of pharmaceuticals;the economic studies are used to grant highest

value to the patient

3

. Pharmacoeconomics, thedescription and analysis of the costs of drugtherapy, can be defined as the branch ofeconomics that uses cost-benefit, cost-effectiveness, cost-minimization, cost-of-illnessand cost-utility analyses to comparepharmaceutical products and treatmentstrategies required for the patients

4-6. The term

pharmacoeconomics was introduced in 1986, atmeeting of pharmacist in Toronto, Canada,

when Ray Townsend from the Upjohn company,used the term in presentation. In addition, Rayand few others performed studies since the earlyeighties using the term pharmacoeconomicswithin the pharmaceutical industry

7. The

pharmacoeconomics has been necessitated inpharmaceutical industry, government, and otherprivate sectors in order to compare various costconsequences

8-9. The measures of costs and

measures of outcomes have been considered as

the two fundamental components ofpharmacoeconomic studies are that arecombined into a quantitative measure, whichcan be done using various methods like cost-minimization analysis (CMA), cost-effectivenessanalysis (CEA), cost-utility analysis (CUA), andcost-benefit analysis (CBA)

10-12. However,

pharmaeconomic studies are the keys by whicha pharmacist may enhance their competent andprofession by applying various methods for

Rev iew Ar t i cl

ABSTRACT

Economic evaluations help to lessen the burden of inadequate resources by improving the the

efficiency of health care financing. Pharrmacoeconomics has been considered as a fundamental

comparison and option, which is required during the purchasing of medicine according to costeffectiveness and short onset of action. The pharmacoeconomic evaluation has been used to

regulate health economics and specific index of medicines rates. Various types ofpharmacoeconomics evaluation has been suggested which include cost-minimization analysis,cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. The

pharmacoeconomics is a part of the tool bag, and clinical pharmacist can use it to improve the

efficiency of his profession. Presently, it has been used to make formulary decisions, designdisease management programs and measuring the cost-effectiveness of interventions and

programs in managed care. This review article emphasize on the evaluation ofpharmacoeconomic studies and the problems faced by them.

Keywords: Pharmacoeconomics, Evaluation, Analysis.

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health economics in the field of variouspharmaceutical policies

13-14. Moreover, the

pharmacoeconomic analysis provides number ofways in order to increase the health economyand index of medicines adjustment

13-15. The

present review article critically discusses aboutvarious pharmacoeconomic concepts andterminology used in a pharmacoeconomic study.

NEEDS AND CHALLENGES OFPHARMACOECONOMICS

Although health economics, a branch ofeconomics is relatively young, but the need ofpharmacoeconomics in pharmaceutical industryhas been alarmed. The pharmacoeconomicshas been noted to be required in industry fordeciding amongst the specific research anddevelopment alternatives; in Government fordetermining program benefits and prices paid;and in private sector for designing insurance

benefits coverage16. Moreover, measures andcomparison of cost alongwith consequences ofpharmaceutical products and services havebeen identified by pharmacoeconomics. Further,the economic relationship involving drugresearch, drug production distribution, storage,pricing and used by the people has beendescribed by the pharmacoeconomics.

Additionally, important points which have beenobserved in any pharmacoeconomics analysisare relative issue; time consuming; price; andresults obtained

7. It has been suggested that

four points are achieved in pharmacoeconomics

analysis which include lower cost, betteroutcome; higher cost, better outcome; lowercost, less outcomes; and higher cost, lessoutcomes

17-18. Despite of smooth application of

pharmacoeconomics in the pharmaceuticalindustry and other private sectors, variouschallenges have been faced bypharmacoeconomic studies, which includeestablishment of guidelines or standards ofpractice; establishment of a cadre of trainedproducers and consumers ofpharmacoeconomic work,;providing educationon the relevant features of this discipline for

practitioners, government officials, private sectorexecutives; and stable funding to supportapplied pharmacoeconomic research

16,19.

METHOD OF PHARMACOECONOMICEVALUATIONThe evaluation of pharmacoeconomic studiescan be done using various methods like cost-minimization analysis (CMA), cost-effectiveness

analysis (CEA), cost-utility analysis (CUA), andcost-benefit analysis (CBA)

20-21. However,

evaluation of pharmacoeconomic studies hasbeen suggested to afford a number ofimportances (Fig 1). The CMA has beendemonstrated to measure the cost andcompares the health care services mainly. It hasbeen known to be applied only in thoseconditions in which the result of therapy isapproximately same as that of standard, whichcan be evidenced from the fact that genericmedicines show same efficacy but have a lotand large difference in their price whilecomparing with branded medicines

22. The

objective of this method is to choose the leastcostly drug amongst multiple equivalentinterventions.Second method of evaluation ofpharmacoeconomic studies is CEA which coversthe time of patient saved and time afforded to

the suffered people without any diseasecondition alongwith the money spent in order toachieve this goal and comparison with thequality of results and outcome of therapy.Further, the results are then plotted and thetreatments which have the lowest cost andhighest effectiveness along the effectivenessfrontier will be preferred

23. However, CEA has

not been permitted to make comparisonbetween two or more separated field ofmedicines with different results.CUA, the third method of evaluation ofpharmacoeconomic studies, matches with CEA

in various conducts. In this method, themeasurement of money occurs according to theresults and outcomes of the therapy

24. The

outcome of the study and cost to reach thatoutcome is measured in monetary terms.However, the results are somehow morevaluable and the finishing of therapy is notrelated to the diseased condition

25.

The fourth method of evaluation ofpharmacoeconomic studies is CBA in which thebenefit is considered as the economic benefitinterference between cost and outcomes. In thismethod, the cost of therapy and consequences,

both are measured in monetary terms andinvolves the evaluation of intangible cost inmonetary value attached to different state ofhealth like physical, emotional and psychologicaldistresses associated with being ill versus beinghealthy

7,26. In addition, CBA has been suggested

to ignore a lot of untouched and very crucialoutcomes or benefits net in the form of money.

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Fig. 1: Importance of Evaluation of Pharmacoeconomic Study

PROBLEMS ASSOCIATED WITHPHARMACOECONOMICS

Pharmacoeconomics has been considered asan evolving science whose methodologies arenot well established, and thus, various problemshave been found to be associated with it. Theproblem has been suggested to continuouslyincrease and result in difficulties to understandthe methodologies for evolution of new drugsand potential therapies

27-28. The major problem

associated with pharmacoeconomic studiesinclude maintaining and creating schemes ofperfect trained employers and consumers ofpharmacoeconomic evaluations; regulating theanalysis on the proper characteristics of thedisciplined manner for practioners, Governmentofficials and private field workers; and absenceof fixed resources to support appliedpharmacoeconomic evaluation

16. Further,

limitations in pharmacoeconomics studiesgenerate lot of problems which reduces the useof health economics in therapy. The healtheconomics has been noted to be misused in themarketed field mainly by the health care payers.Further problems may be attributed to the

improper pharmacoeconomics analysis, which isevident by the fact that selection of improper

drug is done by the clinical pharmacist due tothe marketed pressure29-30

. Moreover, the drugsare prescribed by the medicinal practitioner bythe motivated pressure activity by marketingexecutives and medical representatives ofpharmaceuticals firms who provide incentive tothe medical practitioner for prescribing theirbranded generics or pseudogenerics

7,16.

CONCLUSIONPharmacoeconomic studies have beensuggested to enhance the medical educationwhich technically tells about the diseases andtherapy alongwith the understanding ofsocioeconomic issues. Over the last decadethere has been tremendous interest in economicevaluations of healthcare programmes,especially in the pharmaceutical field. Thesedays, the pharmacoeconomics research is aflourishing industry with many practioners, alarge research and application agenda, several

journals and flourishing professional societiesincluding the international society for

Pharmacoeconomics

Evaluation

Cost-minimization

analysis

Cost-benefit

analysis

Cost-effectiveness

analysis

Cost-utility

analysis

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pharmacoeconomics and outcomes research.However, health economics is an evolvingscience, but its methodologies are as yet notwell established in many areas, and hence, newstudies are demanded in order to completelyunderstand and apply the pharmacoeconomicsin the present world.

REFERENCES1. Picot J, Jones J, Colquitt JL,

Gospodarevskaya E, Loveman E,Baxter L, et al. The clinical effectivenessand cost-effectiveness of bariatric(weight loss) surgery for obesity: asystematic review and economicevaluation. Health Technol Assess2009; 13: 215-357.

2. Loveman E, Frampton GK, Shepherd J,Picot J, Cooper K, Bryant J, et al. Theclinical effectiveness and cost-

effectiveness of long-term weightmanagement schemes for adults: asystematic review. Health Technol

Assess 2011; 15: 1-182.3. Ellis CN, Teiter KL, Wheeler JR,

Fendrick AM. Economic analysis indermatology. J Am Dermatol 2002; 46:271-83.

4. Ahuja J, Gupta M, Gupta AK, Kohli K.Pharmacoeconomics. Natl Med J India2004; 17: 80-3.

5. Arenas-Guzman R, Tosti A, Hay R,Haneke E. Pharmacoeconomics--an aid

to better decision-making. J Eur AcadDermatol Venereol 2005; 19: 34-9.

6. Hirsch BR, Lyman GH.Pharmacoeconomics of the myeloidgrowth factors: a critical and systematicreview. Pharmacoeconomics 2012; 30:497-511.

7. Gattani SG, Patil AB, Kushare SS,Pharmacoeconomics: A Review. AsianJournal of Pharmaceutical and ClinicalResearch 2009; 2: 15-26.

8. Walley T, Haycox A.Pharmacoeconomics: basic concepts

and terminology. Br J Clin Pharmacol1997; 43: 343-8.9. Walley T, Breckenridge A.

Pharmacoeconomics comes of age?.Clin Pharmacol Ther 2008; 84: 279-80.

10. Reeder CE. Overview ofpharmacoeconomics andpharmaceutical outcomes evaluations.

Am J Health Syst Pharm 1995; 52: S5-8.

11. Fuhrlinger S. Relevance ofpharmacoeconomic analyses to priceand reimbursement decisions in Austria.Wien Med Wochenschr 2006; 156: 612-8.

12. Bodrogi J, Kaló Z. Principles ofpharmacoeconomics and their impacton strategic imperatives ofpharmaceutical research anddevelopment. Br J Pharmacol 2010;159: 1367-73.

13. Walley T, Davey P.Pharmacoeconomics: a challenge forclinical pharmacologists. Br J Clin.Pharmacol 1995; 40: 199-202.

14. Czech M. Pharmacoeconomics incontemporary medicine. Pol MerkurLekarski 2004; 16: 16-9.

15. Ahuja J, Gupta M, Gupta AK, Kohli K.Pharmacoeconomics. Natl Med J India

2004; 17: 80-3.16. Lyles A. Recent trends in

pharmacoeconomics: Needs and unmetneeds. Eur J Pharm Sci 2008; 34: S7-S24.

17. Walley T, Edwards RT. Is there a needfor an independent centre forpharmacoeconomics in the UK?.Pharmacoeconomics 1994; 5: 93-100.

18. Lipman AG. Why we need outcomesresearch and pharmacoeconomics inpain management and palliative care. JPain Palliat Care Pharmacother 2002;

16: 1-3.19. Hughes D, Reynolds DJ.

Pharmacoeconomics: principles andrelevance to the activities of drug andtherapeutics committees. Clin Med2009; 9: 490-2.

20. Jolicoeur LM, Jones-Grizzle AJ, BoyerJG. Guidelines for performing apharmacoeconomic analysis. Am JHosp Pharm 1992; 49: 1741-7.

21. Sule NS, Nerurkar RP, Kamath SA.Pharmacoeconomics. J AssocPhysicians India 2002; 50: 1057-62.

22. Newby D, Hill S. Use ofpharmacoeconomics in prescribingresearch. Part 2: cost-minimizationanalysis--when are two therapiesequal?. J Clin Pharm Ther 2003; 28:145-50.

23. Lopert R, Lang DL, Hill SR. Use ofpharmacoeconomics in prescribingresearch. Part 3: Cost-effectivenessanalysis--a technique for decision-

8/9/2019 11-320.pdf



2781

68

making at the margin. J Clin Pharm Ther2003; 28: 243-9.

24. Brinsmead R, Hill S. Use ofpharmacoeconomics in prescribingresearch. Part 4: is cost-utility analysis auseful tool?. J Clin Pharm Ther 2003;28: 339-46.

25. Maynard A. Developing the health caremarket. The Economics J 1991; 101:12TI-1286.

26. Robertson J, Lang D, Hill S. Use ofpharmacoeconomics in prescribingresearch. Part 1: costs--moving beyondthe acquisition price for drugs. J ClinPharm Ther 2003; 28: 73-9.

27. Byford S, Palmer S. Common errors andcontroversies in pharmacoeconomicanalyses. Pharmacoeconomics 1998;13: 659-66.

28. Supe AN. Health economics-Blindspotin current medical teaching. Ind Med

Assoc 2004.29. Muller M. Limitations of

pharmacoeconomics from a clinical-pharmacological point of view. WienMed Wochenschr 2006; 156: 619-21.

30. Krammer H. Pharmacoeconomicanalyses--chance or 4th hurdle forinnovative drugs. Wien MedWochenschr 2006; 156: 606-11.

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