A pharmacoeconomics congress is something a bit special. While in other scientific meetings clinical results, or even those of basic research, are presented, when pharmacoeconomics arrives on the scene, the results are already taken for granted and what is evaluated is the relationship between cost and effectiveness. In short: what is better to buy, for the health of citizens, with the limited funds that are available. It is not easy also because the evaluation of the results from an economic point of view includes in some respects even more variables than those of an evaluation of effectiveness. Variables that change continuously. This was also confirmed by the work of the VI national conference on Pharmacoeconomics held in Milan on 25-26 June. Beyond the object of the individual studies, a change in the general picture has emerged. "When evaluating the use of innovative drugs, one should abandon the financial logic of those who proceed with the purchase year by year and take on a broader point of view" said Maria Caterina Cavallo, of CERGAS at the Bocconi University in Milan, who presented an observational study of trastuzumab, a biological cancer drug that has radically changed the treatment of metastatic breast cancer but comes at a very high price. As Cavallo explained, if the purchase of the drug weighs on the balance sheet at the time it occurs, the benefits, and therefore its effectiveness also on an economic level, develop over time.
Another crucial aspect concerns the carrying out of the studies itself, as the economist Carlo Lazzaro underlined in another report, dedicated to the comparison between anastrozole and tamoxifen, clinical efficacy studies often do not also collect the elements necessary to calculate the utility to the patient from the use of one treatment or another. And then, observed Lazzaro, it would be necessary to establish in a more precise way what are the limits within which a treatment is considered economically compatible. Today, years adjusted for quality of life (QUALY) are used universally, i.e. the survival in acceptable conditions that a drug guarantees is measured. “Except that” said Lazzaro “the maximum value that can be attributed to a QUALY while maintaining economic convenience exists probably too wide a variability. In Italy, at least one research group claims that it can go from 30 to 60,000 euros". A very wide range, therefore.
Giovanni Fattore, professor at the Bocconi Institute of Public Administration and Health, then pointed out a particular aspect destined to assume ever greater importance. With regard to stroke, a disease that mainly affects the elderly, he pointed out that “the social costs are inevitably underestimated, because the elderly do not earn, they are retired, so it is believed that their incapacity does not correspond to lower productivity. But this is not the case: today in Italy the elderly carry out unpaid but often fundamental activities, such as childcare, for example, or support for other elderly people”. And this too is an aspect to consider in the pharmacoeconomic analysis. In the end, it's less and less easy to tell if a cure costs too much for what it gives.
Source www.pharmamarketing.it
Another crucial aspect concerns the carrying out of the studies itself, as the economist Carlo Lazzaro underlined in another report, dedicated to the comparison between anastrozole and tamoxifen, clinical efficacy studies often do not also collect the elements necessary to calculate the utility to the patient from the use of one treatment or another. And then, observed Lazzaro, it would be necessary to establish in a more precise way what are the limits within which a treatment is considered economically compatible. Today, years adjusted for quality of life (QUALY) are used universally, i.e. the survival in acceptable conditions that a drug guarantees is measured. “Except that” said Lazzaro “the maximum value that can be attributed to a QUALY while maintaining economic convenience exists probably too wide a variability. In Italy, at least one research group claims that it can go from 30 to 60,000 euros". A very wide range, therefore.
Giovanni Fattore, professor at the Bocconi Institute of Public Administration and Health, then pointed out a particular aspect destined to assume ever greater importance. With regard to stroke, a disease that mainly affects the elderly, he pointed out that “the social costs are inevitably underestimated, because the elderly do not earn, they are retired, so it is believed that their incapacity does not correspond to lower productivity. But this is not the case: today in Italy the elderly carry out unpaid but often fundamental activities, such as childcare, for example, or support for other elderly people”. And this too is an aspect to consider in the pharmacoeconomic analysis. In the end, it's less and less easy to tell if a cure costs too much for what it gives.
Source www.pharmamarketing.it
