The increasing importance of cost effective analyses. Theory and practice of pharmacoeconomic research

In this paper we consider the Dutch guidelines for pharmacoeconomic research in relation to recently published pharmacoeconomic analyses. The Dutch guidelines specify 19 aspects. We investigated whether analyses already adhered to five methodological guidelines: the societal perspective should be taken; an adequate time horizon for analysis should be deployed; explicit distinction should be made between efficacy and effectiveness; an incremental approach should be taken; and costs, benefits and health effects should be discounted. Studies were selected if published in Dutch in the period 1991-2002, resulting in a total of 20 studies selected. The majority of studies already adhered to 4 of the 5 the guidelines, suggesting that no major changes in conducting studies is required. However, less than 50% of the studies already adhered to the guideline on the societal perspective. In particular, indirect costs of production losses were often not included. We conclude that with respect to adherence to the Dutch guidelines for pharmacoeconomic research, inclusion of indirect costs into pharmacoeconomic analyses presents an important challenge for Dutch pharmacoeconomist in the upcoming years