ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04397.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Outcomes research has developed in response to the need for information on costs, risks, and benefits of clinical treatments, including data regarding the effectiveness of prescription drugs. It attempts to consider more than the biologic effects of pharmaceuticals, that is, to encompass wider measures of the results of their use, issues that are not routinely addressed during clinical trials. Cost‐effectiveness analysis compares the outcome of different treatment options in terms of monetary cost per unit of effectiveness. Examples of measures of effectiveness are years of life saved, number of days of hospitalization avoided, and number of treatment successes. Cost‐consequence models, also referred to as cost‐outcome models, deal with costs and a variety of outcomes ranging from clinical to humanistic. Direct medical costs are those for prevention, detection, treatment, and rehabilitation; they are amounts spent to treat an illness, including hospitalization, professional services, pharmaceuticals, and medical supplies. Indirect medical costs are associated with changes in productivity, such as earnings lost because of illness. Humanistic outcomes deal primarily with functional status, quality of life, and satisfaction, and may include pain, anxiety, self‐esteem, ability to carry out normal activities, and overall impressions. Since it is not possible to study all effects of treatments with clinical trials, modeling techniques are useful in making therapeutic de

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04398.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Human herpesvirus infections continue to be a concern in immunocompetent as well as immunocompromised hosts. They are often life threatening in the immunocompromised patient. In the healthy immunocompetent person the infections tend to be self‐limited, although they can directly or indirectly cause periods of severe discomfort and disability, and their treatment can affect productivity, as shown by cost‐outcome models. Treatment of primary or secondary episodes in the immunocompetent host is therefore directed toward more rapid resolution of initial and recurrent episodes, thereby limiting the impact of the infecti

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04399.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Three cost‐consequence models were developed for treatment of infections due to varicella‐zoster virus (VZV) with acyclovir in immunocompetent patients—adult‐ and childhood‐onset chickenpox, and herpes zoster (shingles) in adults. For chickenpox, separate models allow examination of differences in severity and impact of the disease for children and adults, as well as in the management of civilians and adults in military service. Each model includes direct medical costs, indirect costs and health‐related productivity loss, symptom and quality of life impact, and model assumptions and conclusions. Alternatives of treatment and no treatment are addressed. Quality of life impact is conceptualized in terms of a quality‐adjusted life‐days decrement due to VZV symptoms of importance to the patient, such as pain, rash, and itching. As experience and data become available, alternative agents such as valacyclovir and famciclovir for the treatment of patients with herpes zoster should be included in the m

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04400.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Functioning effectively as a pharmacy benefit manager has been defined as purchasing the best product at the lowest possible cost. In the simplest terms, this means purchasing discounted drugs; in the most complex terms, it means managing drug use. However, if the entire medical picture were analyzed, use of more expensive drugs might actually lower total direct medical costs. Currently, formulary decisions are based on both therapeutic necessity and cost. The decision to administer one drug rather than another is directed by community practice patterns and the final price. The availability of information to demonstrate differences, if any, in total treatment costs between the two agents would considerably enhance therapeutic decision making and would guide treatment by an outcome‐based drug formulary. The question that requires an answer is centered on the value equation: Value = outcomes/cost. Before paying more for drug A than for drug B, the payer will demand to see value. When available, direct and indirect cost information will be applied to position drugs appropriately in a drug formular

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04401.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1995.tb04402.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY