Pharmacoeconomic studies: are they relevant?

Pharmacoeconomic studies are more and more considered to be part of both me dical practice and evaluation. Today they are essential to drug registratio n. The implementation of clinical studies includes many difficulties, as co sts have to be precisely defined. Depending on the type of clinical study, the pharmacoeconomic study may be aimed at lowering the costs; it may also be either a cost-efficacy, a cost-benefit or a cost-utility analysis. Diffi culties are maximal in intensive care. An analysis of two examples issuing from the nomenclature of homogenous groups of patients shows the inadequacy of this classification actuary in Intensive care and for the analyses of d rug cost. In regard to intensive care, difficulties in evaluating properly the cost of nosocomial infections is illustrated through concrete examples. (C) 2000 Editions scientifiques et medicales Elsevier SAS.