Application of pharmacoeconomics to formulary management in a health system setting.
Am J Health Syst Pharm
; 76(6): 381-386, 2019 Feb 21.
Article
em En
| MEDLINE
| ID: mdl-31361838
ABSTRACT
PURPOSE:
A novel value-based approach to evaluate costly specialty drugs for formulary addition was developed.SUMMARY:
In February 2016, Stanford Health Care launched the specialty drug subcommittee (SDSC), a subcommittee of the pharmacy and therapeutics committee, responsible for the formulary review of specialty pharmaceuticals. A process was developed for value-based review that includes not only consideration of clinical trial data and institutional acquisition costs but also internal patient outcomes and a cost-effectiveness model using internal financial data. A Markov model was developed to assess the value of trabectedin, which was approved for formulary addition in April 2016, relative to the addition of dacarbazine. The economic model and internal patient outcome analysis were presented to the prescribing oncologist and the SDSC for review. Internal data revealed that fewer patients than had been estimated received trabectedin, with outcomes significantly worse than those observed in the clinical trial leading to Food and Drug Administration approval. In the cost-effectiveness model, trabectedin had higher costs and poorer outcomes compared with dacarbazine. Based on the economic model, low utilization, and real-world outcomes, trabectedin was removed from formulary and a restrictive treatment pathway for nonformulary use, developed by the primary prescriber, was implemented. This process has since been applied to 11 more specialty drugs.CONCLUSION:
Internal cost-effectiveness models in combination with real-world patient outcomes data can be effective formulary management tools. Engagement and collaboration with the requesting provider are key to developing thoughtful treatment pathways.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Financiamentos_gastos
/
Gestao
Bases de dados:
MEDLINE
Assunto principal:
Comitê de Farmácia e Terapêutica
/
Assistência Farmacêutica
/
Análise Custo-Benefício
/
Farmacoeconomia
/
Formulários Farmacêuticos como Assunto
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Health Syst Pharm
Assunto da revista:
FARMACIA
/
HOSPITAIS
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Canadá