GUIDELINES FOR PHARMACOECONOMIC STUDIES - RECOMMENDATIONS FROM THE PANEL ON COST-EFFECTIVENESS IN HEALTH AND MEDICINE

This article reports the recommendations of the Panel on Cost Effectiv eness in Health and Medicine, sponsored by the US Public Health Servic e, on standardised methods for conducting cost-effectiveness analyses. Although not expressly directed at analyses of pharmaceutical agents, the Panel's recommendations are relevant to pharmacoeconomic studies. The Panel outlines a 'Reference Case' set of methodological practices to improve quality and comparability of analyses. Designed for studie s that inform resource-allocation decisions, the Reference Case includ es recommendations for study framing and scope, components of the nume rator and denominator of cost-effectiveness ratios, discounting, handl ing uncertainty and reporting. The Reference Case analysis is conducte d from the societal perspective, and includes all effects of intervent ions on resource use and health. Resource use includes 'time' resource s, such as for caregiving or undergoing an intervention. The quality-a djusted life-year (QALY) is the common measure of health effect across Reference Case studies. Although the Panel does not endorse a measure for obtaining quality-of-life weights, several recommendations addres s the QALY. The Panel recommends a 3% discount rate for costs and heal th effects. Pharmacoeconomic studies have burgeoned in recent years. T he Reference Case analysis will improve study quality and usability, a nd permit comparison of pharmaceuticals with other health intervention s.