| Summary: | Abstract
Objective: economic evaluation is a fundamental criterion
when deciding a drug’s place in therapy. The MADRE method
(Method for Assistance in making Decisions and Writing Drug
Evaluation Reports) is widely used for drug evaluation. This
method was developed by the GENESIS group of the Spanish
Society of Hospital Pharmacy (SEFH), including economic evaluation.
We intend to improve the economic aspects of this
method. As for the direction to take, we have to first analyze
our previous experiences with the current methodology and
propose necessary improvements.
Method: economic evaluation sections in collaboratively conducted
drug evaluation reports (as the scientific society, SEFH)
with the MADRE method were reviewed retrospectively.
Results: thirty-two reports were reviewed, 87.5% of them
included an economic evaluation conducted by authors and
65.6% contained published economic evaluations. In 90.6%
of the reports, a Budget impact analysis was conducted. The
cost per life year gained or per Quality Adjusted Life Year gained
was present in 14 reports. Twenty-three reports received
public comments regarding the need to improve the economic
aspect. Main difficulties: low quality evidence in the target population,
no comparative studies with a relevant comparator,
non-final outcomes evaluated, no quality of life data, no fixed
drug price available, dosing uncertainty, and different prices
for the same drug.
Conclusions: proposed improvements: incorporating different
forms of aid for non-drug costs, survival estimation and adapting
published economic evaluations; establishing criteria for
drug price selection, decision-making in conditions of uncertainty
and poor quality evidence, dose calculation and cost-effectiveness
thresholds depending on different situations
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