Pharmacoeconomic paper
Write a critique of a pharmacoeconomic paper.
You will be required to submit a 500-1000 word report suitable for submission to your manager to be considered by the Pharmacy and Therapeutics Committee. It will describe the results of your thorough critique and any other research that you may have done to complete your critique. Also submit a PDF of the paper that you reviewed even if you use one of the papers I provide.
Your critique of the pharmacoeconomic paper quality should be based on the questions presented as ‘A check-list for assessing economic evaluations’, as set out in Drummond, M.F, O’Brien, B., Stoddart, G.L., and Torrance, G.W., Methods for the Economic Evaluation of Health Care Programs, 4th edition Oxford/New York/Toronto: Oxford University Press which are also found online through links provided in the material to the National Library of Medicine (NLM).Use the below worksheet which summarizes the questions provided by Drummond et al., and the NLM. The Drummond evaluation framework to be used is attached, ensure to use this framework for the assignment.
The concepts by Drummond et al. needed for this assignment can be found below:
Module 3 National Library of Medicine:
Module 4 National Library of Medicine:
Additional helpful resource:
Please see attached and below:
Pharmacoeconomics:
Critical Appraisal Format (Drummond, et al)
Q.1.1. Did the study examine both costs and consequences of the service(s) or program(s)?
Q.1.2. Did the study involve a comparison of alternatives?
Q.1.3. Was a particular viewpoint (perspective) for the analysis stated, and was the study placed in any particular decision-making context?
Q.2.1. Were any important alternatives omitted?
Q.2.2. Was (Should) a do-nothing alternative (be) considered?
Q.3.1. Was this done through an RCT? If so, did the trial protocol reflect what would have happened in regular practice?
Q.3.2. Was effectiveness established through an “overview” of clinical studies?
Q.3.3. Were observational data or assumptions used to establish effectiveness? If so, what are the potential biases in results?
Q.4.1. Were the ranges of costs and consequences wide enough for the research question at hand?
Q.4.2. Did the ranges of costs and consequences cover all of the viewpoints specified and appropriate to the specified purpose of the study? (Possible viewpoints include those of whole community [i.e., “societal”], provincial government, Ministry of Health, other third-party payors, hospital, and patients and family.) Other viewpoints may also be relevant depending upon the particular analysis.)
Q.4.3. Were capital costs, as well as operating costs, included?
Q.5.1. Were any of the types of identified costs and consequences omitted from measurement and subsequent consideration? If so, does this mean that they carried no weight in the subsequent analysis?
Q.5.2. Were there any special circumstances (e.g., joint use of resources) that made measurement difficult? Was the impact of these circumstances handled appropriately?
Q.5.Overall – Were all the important and relevant types of costs and consequences for each alternative identified, measured and considered in the study? Explain your answer briefly.
Q.6.1. Were the sources of all such values clearly defined? (Unit costs might be based on market values [ e.g. hospital acquisition costs of medications, hourly rate paid for pharmacists’ time, physician billing rates]), or derived from other sources (e.g., a CCOTHA listing of costs; a calculation of private sector hospital billing to patients, adjusted downward by the hospital’s mark-up over its acquisition cost). If consequences are expressed in subjective units (rather than “physical units” such as lives saved or life-years-saved, or infections avoided) , they might be based on patient or client preferences or views of policy-makers, or health professionals.)
Q.6.2. Were market values employed for changes involving resources gained or depleted?
Q.6.3. Where market values were absent (e.g., volunteer labour), or market values did not reflect actual values (such as clinic space donated at a reduced rate), were adjustments made to appropriate market values?
Q.6.4. Was the valuation of consequences appropriate for the question posed (i.e., has the appropriate type or types of analysis—cost-effectiveness, cost-utility, cost-benefit— been selected)?
Q.7.1. Were costs and consequences which occur in the future discounted to their “present” values (i.e., values in the base year, Year 1)?
Q.7.2. Was any (reasonable) justification given for the discount rate used?
Q.8.1. Were the additional (incremental) costs generated by one alternative over the other compared to the additional effects, benefits, or utilities generated?
Q.9. 1. If data on costs or consequences were stochastic, were appropriate statistical analyses performed?
Q.9.2. If a sensitivity analysis was employed, was justification provided for the range of values (for key study parameters)?
Q.9.3. Were study results sensitive to changes in the values (within the assumed range for sensitivity analysis, or within the confidence interval around the ratio of costs to consequences)?
Q. 10.1. Were the conclusions of the analysis based on some overall index or ratio of costs to consequences (e.g., cost-effectiveness ratio)? If so, was the index interpreted intelligently or in a mechanistic fashion?
Q.10.2. Were the results compared with those of others who have investigated the same question?
Q.10.3. Did the study discuss the generalizability of the results to other settings and patient (client) groups?
Q.10.4. Did the study allude to, or take account of, other important factors that would be relevant for decision makers in making the decision under consideration (e.g., beyond the incremental cost-effectiveness ratio, should the decision maker give particular attention to the distribution of costs and consequences among the various relevant parties, or particular ethical issues)?
Q.10.5. Did the study discuss issues of implementation, such as the feasibility of adopting the preferred programme given existing financial (budget) or other constraints, and whether any freed resources could be redeployed to other worthwhile programmes?
