Pharmacoeconomic Modelling for Value-Based Pricing in Malaysia

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: Using Pharmacoeconomic Modelling to Determine Value-Based Pricing for New Pharmaceuticals in Malaysia
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

George Dranitsaris, Ilse Truter, Martie S Lubbe, Nitin N Sriramanakoppa, Vivian M Mendonca, Sangameshwar B Mahagaonkar


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Using Pharmacoeconomic Modelling to Determine Value-Based Pricing for New Pharmaceuticals in Malaysia

Year: 2011

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Decision analysis (DA) serves as a significant tool in the economic evaluation of new pharmaceuticals, particularly in determining the value for money related to cancer treatments. This study specifically examined bevacizumab, a drug that has shown a mere 1.4-month survival benefit for patients with metastatic colorectal cancer (mCRC). By utilizing Malaysia's gross domestic product (GDP) as a threshold set by the World Health Organization (WHO), the study aimed to estimate a cost-effective price per dose for bevacizumab, thereby conducting a thorough economic evaluation and illustrating the relationship between drug pricing and health benefits.

Cost-Effectiveness Analysis of Bevacizumab

A crucial aspect of the study involved a cost-utility analysis centered on the drug bevacizumab, which indicated that its current pricing is not cost-effective given its limited survival benefit of 1.4 months. The analysis utilized decision trees and economic data from various healthcare institutions, providing insights into treatment costs and health state utilities derived from a sample of oncology nurses. The results highlighted that a cost-effective price per dose could not be established; only under hypothetical scenarios where the survival benefit was increased to 3 or 6 months was a feasible price calculated ($567 and $1258, respectively). In contrast, the current market price of approximately $1800 per dose makes it significantly beyond cost-effective thresholds as per WHO’s criteria.

Conclusion

In summary, this study demonstrated the practicality of decision analysis in setting drug prices according to predetermined economic thresholds. It established that bevacizumab, despite being a prominent option for mCRC, offers insufficient survival benefit to justify its current price in Malaysia, emphasizing the necessity for either improved efficacy or reduced pricing to achieve a cost-effective determination. This approach not only serves the interests of healthcare providers and policymakers but also aids in negotiating fair pricing for pharmaceuticals in order to enhance patient access to effective treatments.

FAQ section (important questions/answers):

What is the purpose of decision analysis in pharmaceuticals?

Decision analysis is used to evaluate the economic value of new drugs by comparing their costs and outcomes, helping determine if they offer good value for money based on established thresholds.

How was the price of bevacizumab estimated in this study?

The price per dose of bevacizumab was estimated using a target threshold of $44,400 per QALY gained, based on the survival benefit of 1.4 months when the drug is added to chemotherapy.

What were the results regarding the cost-effectiveness of bevacizumab?

The study found that a cost-effective price for bevacizumab could not be determined due to insufficient survival benefits. Only increased survival durations led to potential price points that adhere to cost-effectiveness criteria.

What are quality-adjusted life years (QALYs) in this study?

QALYs measure the impact of interventions by accounting for both quantity and quality of life. They help quantify the value of treatments like bevacizumab compared to standard options in terms of health outcomes.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Pharmacoeconomic Modelling for Value-Based Pricing in Malaysia”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Drug:
In the context of healthcare and economics, 'drug' refers to pharmaceutical agents like bevacizumab used for treatment. Understanding the cost-effectiveness of drugs is crucial, as seen in its economic evaluation against outcomes such as survival benefit and side effects. This impacts pricing strategies and healthcare funding.

2) Cancer:
Cancer is a significant public health challenge characterized by uncontrolled cell growth. In this study, metastatic colorectal cancer (mCRC) is specifically addressed, highlighting the importance of analytical approaches in determining the economic viability of treatments that offer marginal survival benefits. Such analyses inform clinical decisions and healthcare policies.

3) Chemotherapy:
Chemotherapy is a common cancer treatment involving drugs that target rapidly dividing cells. The study evaluates the cost-effectiveness of chemotherapy regimens combined with innovative drugs. Understanding its benefits versus side effects and overall impact on patient quality of life helps guide treatment decisions and health resource allocation.

4) Line:
In oncology, the term 'line' refers to the sequence of cancer treatment therapies patients undergo, such as first-line or second-line treatments. The study focuses on treatment lines for mCRC, assessing how the addition of therapies like bevacizumab influences overall survival and cost-effectiveness metrics important for formulary decisions.

5) Disease:
The term 'disease' encompasses the range of health conditions impacting patient wellbeing. In this study, mCRC represents a specific disease that necessitates rigorous evaluation of treatment options in terms of both clinical and economic outcomes. The interplay between disease progression, treatment efficacy, and costs drives healthcare decisions.

6) Death:
Death, particularly cancer-related mortality, is a critical endpoint in clinical studies. In evaluating treatment, understanding how therapies like bevacizumab affect survival duration is paramount. The study emphasizes the importance of mortality outcomes in shaping the cost-effectiveness of interventions and the subsequent implications for patient care.

7) Study (Studying):
A 'study' in this context refers to the research evaluating the economic impact of bevacizumab on mCRC treatment outcomes. It involves systematic methodologies, such as decision analysis modeling, to assess pharmacoeconomics, establish price thresholds based on societal willingness to pay, and inform healthcare policy decisions.

8) Table:
Tables in research present data concisely, facilitating comparison of outcomes, costs, and utilities. They summarize clinical trial results and economic data, playing a crucial role in conveying findings about treatments’ effectiveness, costs associated with healthcare delivery, and implications for decision-making in patient management.

9) Toxicity:
Toxicity refers to the adverse effects of treatments like chemotherapy and monoclonal antibodies on patients. Evaluating toxicity is essential in the study to understand patient quality of life and the overall value of treatment options. It significantly influences treatment discontinuation rates and hence cost-effectiveness analyses.

10) Quality:
Quality pertains to the overall health outcomes and life experiences of patients undergoing treatment. The study emphasizes quality-adjusted life years (QALYs) as a measure for assessing the trade-off between treatment benefits and adverse effects, thus providing a framework for determining the cost-effectiveness of available therapies.

11) Life:
Life, or more specifically quality of life, is a central focus in health economics. In this study, life expectancy gains from treatments like bevacizumab are calculated in terms of QALYs. This measurement helps healthcare decision-makers balance costs with health gains, reflecting the value of expensive treatments.

12) Family:
Family considerations might include the emotional and social impacts of cancer treatment on patients and their loved ones. While not the primary focus, understanding familial contexts can enrich quality of life assessments. A family history of cancer might influence individual perceptions of treatment risk and benefit.

13) Trade:
Trade, in this context, refers to the trade-off patients may face regarding length and quality of life when considering treatments. The time trade-off (TTO) method used in the study helps quantify patient preferences between living with treatment side effects versus optimal health, guiding treatment decisions and health evaluations.

14) Medicine:
Medicine embodies the science and practice of diagnosing and treating diseases. The study applies economic evaluation methods within the field of medicine to assess the cost-effectiveness of cancer therapies, showcasing how economic insights can influence clinical practices and healthcare policies toward better treatment outcomes.

15) Tree:
Tree, referring to decision trees, is a modeling technique used to visually represent treatment options and outcomes. The study uses this method to analyze potential scenarios for chemotherapy in mCRC, illustrating how decision analysis helps in evaluating the economic ramifications of various treatment pathways.

16) Knowledge:
Knowledge encompasses both clinical understanding and awareness of treatment costs and outcomes. The study emphasizes that healthcare professionals must integrate knowledge of clinical efficacy and economic evaluations to make informed decisions about drug usage and its affordability within their health systems.

17) Bleeding:
Bleeding is a possible adverse effect of cancer treatments like bevacizumab. Identifying and quantifying such side effects is vital to the economic analysis, as it impacts the overall quality of life for patients and factors into the assessment of the treatment's cost-effectiveness regarding healthcare resources.

18) Money:
Money signifies the financial implications associated with healthcare treatments. The study evaluates drug prices, treatment costs, and healthcare expenditures while aiming to establish economic thresholds for cost-effectiveness, thereby influencing budgetary considerations in public health and pharmaceutical pricing strategies.

19) Pharmacotherapy:
Pharmacotherapy refers to the use of pharmaceutical drugs to treat diseases. The focus on pharmacotherapy in the study underscores the need for thorough evaluations of drugs, such as bevacizumab, in terms of their efficacy, side effects, and overall economic impact on healthcare systems and patient management.

20) Performance:
Performance relates to the effectiveness of treatments in achieving desired outcomes, such as prolonged survival in cancer patients. The study examines drug performance critically, particularly how small improvements in survival can significantly affect cost-effectiveness calculations, influencing patient care decisions and healthcare policies.

21) Mason:
Mason likely refers to a contributor or co-author involved in the study, possibly reflecting expertise in healthcare economics or pharmacotherapy. The contributions of individual authors enhance the credibility and diverse perspectives presented in the study regarding the economic evaluations conducted.

22) Field:
Field refers to the area of expertise or practice, such as oncology, pharmacoeconomics, or medical decision-making. The study draws upon specialized knowledge across health sectors to evaluate treatment effects, helping interpret the intricate relationships between cancer drugs, patient outcomes, and economic viability.

23) Sah:
Shah likely denotes a co-author in the research study, contributing to the analysis or interpretation of findings. Recognizing each author's input underscores the collaborative nature of the research, where diverse expertise coalesces to inform potential guidelines regarding pharmaceutical pricing and treatment outcomes.

24) Gold (Golden):
Gold potentially represents an author associated with this economic evaluation research. Author recognition emphasizes the collaborative approach taken in the study, providing insights into healthcare costs and effectiveness of treatments for mCRC, thereby fostering informed decision-making in cancer treatment management.

25) Ter:
Ther, likely an abbreviation related to therapy or therapeutic approaches explored in the study, encapsulates the focus on evaluating specific treatments for mCRC. Understanding various therapeutic options highlights the significance of comparative effectiveness research in informing clinical pathways and associated costs.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Pharmacoeconomic Modelling for Value-Based Pricing in Malaysia’. Further sources in the context of Science might help you critically compare this page with similair documents:

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