7/27/2019 hw hetar
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OUTCOMES EVALUATED IN PHARMACOECONOMICAL STUDIES
In pharmacoeconomical research, an outcome is a consequence of
drug therapyintervention. The primary drug therapy outcomes that
pharmacoeconomical researchtypically evaluates are clinical
outcomes, humanistic outcomes, and economic
outcomes. Clinical outcomes include the results of treatment
with a drug and may beboth favorable and unfavorable. Therefore,
when pharmacoeconomical studies developclinical outcome measures,
investigators must consider all potential consequences of atherapy,
not just the benefits.
In contrast to clinical outcomes, humanistic outcomes look at a
therapy from thepatients' points of view. These outcomes address
such questions as how the patientfeels and what they perceive their
quality of life to be. A drug that prolongs a patient'slife may not
be considered beneficial by the patient if he or she believes
quality of lifehas become suboptimal. For instance, a patient with
a catastrophic illness may notvalue a drug that prolongs his or her
life in the same way that a patient with a less
serious medical problem would. Therefore, humanistic outcomes
are very important inassessing the overall value of a
medication.
Economic outcomes are the costs associated with a therapy.
Several different types ofcosts are measured in pharmacoeconomical
research. The first type of costs is directcosts, which may be both
medical and nonmedical. Direct medical costs are associatedwith the
drug and the medical care itself and would include acquisition
costs,monitoring costs, preparation costs, and physicians' fees.
Direct medical costs alsoinclude the cost of administrating the
medication as well as the cost of treating anadverse drug reaction.
Direct nonmedical costs are those that are relevant to providingthe
therapy and include transportation to a health care facility and
ancillary support,
such as social services and home care services.
Indirect costs result from loss of productivity due to illness.
These are costs associatedwith the morbidity and mortality of a
disease. Although these costs are not universallyaccepted as being
important, they may significantly affect the total cost of a
disease.
Intangible costs are more difficult to assign a dollar value.
These are costs associatedwith pain and suffering of disease and
may greatly affect a patient's well-being andquality of life. How
does one put a specific dollar amount on pain and suffering?
Somepharmacoeconomical studies use survey instruments to assess
quality of life to measure
these important costs in a nonmonetary way.
In reviewing the pharmacoeconomical literature, one should
carefully evaluate the costsused in conducting studies to make sure
that all appropriate costs have been included.Failure to consider
this information may lead to inaccurate conclusions. In addition,
oneshould also determine whether the costs cited are relevant to
the organization. Manypharmacoeconomical studies use average
wholesale price (AWP) when comparingtherapies; however, if the cost
to the organization differs significantly from the AWP,then the
study results may not be relevant.
