Is There A Role For Pharmacoeconomics In Developing Countries?
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Pharmacoeconomics 2010; 28 (12): 1069-1074 1170-7690/10/0012-1069/$49.95/0
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Is There a Role for Pharmacoeconomics in Developing Countries? Zaheer-Ud-Din Babar and Shane Scahill School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
The special issue of PharmacoEconomics[1] pertaining to developing nations was a welcome move, with authors discussing various themes relating to pharmaceutical economics. The topics discussed included cost-effectiveness analyses and the future of health technology assessment (HTA) in healthcare decision making in the greater Asia region. However, papers in this special issue did not provide an answer to a fundamental question: why is pharmacoeconomics vital for developing countries? Pharmacoeconomics is a complex science and its practical utility depends on the context in which it is being applied. To appreciate the true value of this ‘science’ as a decision-making tool, it is important to elaborate on the context within which healthcare decisions are being made. Furthermore, an understanding of the local health system is also required in order to establish whether complex economic techniques need to be applied and whether they are feasible and valuable tools for a particular jurisdiction. We argue that there is a need for a model that could aid in determining the perceived need and benefits of using pharmacoeconomics in formulary development in a given developing country. However, we do not present a full model; rather, we highlight some of the components that could be used to build such a model. Health and pharmaceutical indicators from international agencies, evidence-based pharmacy-system research as well as the literature concerning ‘how people perceive pharmacoeconomics’ in developing countries could serve as these components.
1. The Use and Understanding of Pharmacoeconomics in Developing Countries The application of pharmacoeconomics for comparing pharmacy services and treatment options is an accepted and valuable tool.[2] However, the utility of pharmacoeconomics for selecting drugs for national medicines formularies depends on various factors, including health system design and performance, the pharmaceutical situation[3] and the country’s expenditure on pharmaceuticals (evaluating the pharmaceutical situation of a country requires pharmaceutical sector assessment, including whether people have access to safe, effective and affordable essential medicines of acceptable quality). We argue that it may not be necessary for many low-income countries to use complex ‘costutility or cost-effectiveness techniques’ for selecting drugs for a national formulary. A medicine pricing policy could work as a first-line tool. In the recent issue of PharmacoEconomics, Yang[4] outlined the growth of pharmacoeconomics in Asia; however, he did not differentiate between countries (while discussing the utility of pharmacoeconomics), nor did he allude to any country-specific cost-effectiveness t
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