Do reassessments reduce the uncertainty of decision making? Reviewing reimbursement reports and economic evaluations of three expensive drugs over time.
Health Policy
; 112(3): 285-96, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-23628483
ABSTRACT
OBJECTIVE:
To investigate the desirability and feasibility of a cyclic reimbursement process to address uncertainty accompanying initial decision making.METHODS:
We performed desk research for three expensive outpatient drugs imatinib, pegfilgrastim, and adalimumab. We analysed the evidence base at the time of decision making (T=0) and May 2011 (T=1). For T=0, public reports of the Dutch reimbursement agency were investigated regarding available clinical and economic evidence, and a systematic review was performed to retrieve additional economic evidence. For T=1, the systematic review was extended till May 2011.RESULTS:
The evidence base at T=0 lacked information on clinically relevant outcomes such as mortality, morbidity, and quality of life (5/8 reports), (long-term) adverse events (2/8 reports) and experience in use (1/8 reports). One budget impact analysis and one economic evaluation were available but no pharmacoeconomic dossiers. The systematic review identified 39 cost-utility studies (of 52 economic evaluations) for T=1, characterised by methodological heterogeneity.CONCLUSIONS:
Given the considerable uncertainty accompanying initial decision-making, a more cyclic reimbursement process seems feasible to reduce uncertainty regarding the therapeutical and economical value of expensive drugs. A mandatory evidence development requirement seems desirable to sufficiently meet decision makers' needs.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Avaliacao_economica
/
Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Piperazinas
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Pirimidinas
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Benzamidas
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Fator Estimulador de Colônias de Granulócitos
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Tomada de Decisões
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Incerteza
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Anticorpos Monoclonais Humanizados
/
Reembolso de Seguro de Saúde
/
Anti-Inflamatórios
/
Antineoplásicos
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Health Policy
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SAUDE PUBLICA
Ano de publicação:
2013
Tipo de documento:
Article