COST-EFFECTIVENESS - FROM WHOSE PERSPECTIVE

Evaluating the cost-effectiveness of medical interventions, particular ly pharmaceuticals, has been the focus of much debate in this country over the past few years. Although the support for efficient utilizatio n of monies is widespread, the delicate balance between optimizing pat ient outcome with the costs to do so in high-risk patients is especial ly difficult. Although research in the field of cost-effectiveness is widespread, at present there are few guidelines in this country. Furth ermore, the introduction of bias is a serious concern in the interpret ation and validation of studies, often limiting their utility. Guideli nes that can be implemented to minimize bias in economic research have been identified to include administrative, methodology-based, and eth ical parameters. The standardization and implementation of such guidel ines can reduce bias in economic research and optimize study validity. This review focuses on these issues and suggests that initial steps t o produce unbiased economic research include total disclosure, appropr iate comparator selection, complete release of all relevant data, and the cooperation of all involved parties.