[e-drug] Pharmacoeconomics and role in drugs selection (2)

["Douglas Ball" <douglasball@yahoo.co.uk>]

E-DRUG: Pharmacoeconomics and role in drugs selection (2)
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Pharmacoeconomics is a valid tool for selection of drugs for formulary or essential medicines lists. It is increasingly being used for this purpose with the realisation that healthcare and drug spending is increasing at a rate greater than national economic growth in most if not all countries. It is used by NICE (UK) to guide decisions on some drugs and health technologies to reimburse on the NHS, PBS (Australia) for deciding what drugs to list for reimbursement and to set their price/value and also in other European nations for similar reasons. Some Canadian formularies use pharmacoeconomic criteria to guide listing decisions as does the Veterans Administration in the USA and some HMOs. The application varies from being applied to all medicines to just being used for selected difficult cases.

Is it a reliable tool? The simple answer is probably 'Yes' provided that there is sufficient evidence to support the models and sufficient expertise to evaluate them. Most systems that use it require the pharmaceutical companies to supply pharmacoeconomic data to support their application for listing or reimbursement, but there is good evidence that their evaluations are biased towards showing their products as cost-effective compared to other alternatives, etc. Therefore there needs to be some local expertise as well - whether just to just evaluate the submissions or to develop independent models/analysis. 

There is a lot of scope for applying this in Kuwait - whether at national level for determining what medicines should be made available through Central Medical Stores on the public health list/EML or deciding which medicines should have restricted benefit i.e. be restricted to GCC/Kuwaiti residents. It also could be applied in setting medicine prices or developing an alternative payment mechanism for private pharmacies. It would be particularly useful given the strong brand recognition in Kuwait and the powerful promotion of pharmaceutical companies - pharmacoeconomic analysis would provide information to help reach more informed decisions on the most appropriate medicines to make available. Your dissertation will be relevant and your expertise valuable when you return to Kuwait.

All the best with your studies. Feel free to contact me if you want to discuss it further.

Regards

Douglas 
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Dr. Douglas Ball  
BSc(Pharm), MSc, MMedSc(ClinEpid), PhD
Dept. of Pharmacy Practice
Faculty of Pharmacy, Health Sciences Center
University of Kuwait, PO Box 24923 Safat 13110
Kuwait
Tel: (965)498 6073 or 531-2300 ext. 6073
Mobile: (965) 7975483
Fax (personal): (1)866-284-1909
Fax (work): (965)498-6840 /534-2807
E-mail: dball@hsc.edu.kw
douglasball@yahoo.co.uk