Integrating Adherence Into Pharmacoeconomic Analyses
Integrating Adherence Into Pharmacoeconomic Analyses
Given that compliance and persistence affect both health outcomes and costs, these concepts should be included to accurately estimate the cost–effectiveness of drug therapies. In our example using observational data (Figure 3), the impact of medication adherence on cost–effectiveness is substantial. The incremental cost per QALY gained of oral bisphosphonates compared with no treatment was estimated at €10,279 and €3909 at real-world and full (assumed) adherence levels, respectively. In this example, poor adherence therefore results in around a doubling of the cost–effectiveness from these medications. It means that for example, with a budget of €20,000, treatment with oral bisphosphonates could save 1.95 life-years in perfect health at real-world adherence levels while, at full adherence, treatment could preserve 5.12 life-years in perfect health. The studies addressing compliance and persistence have shown that both aspects of adherence were important drivers of cost–effectiveness.
(Enlarge Image)
Figure 3.
Impact of medication nonadherence on the cost–effectiveness (expressed as cost in euros per quality-adjusted life-year gained) of oral bisphosphonates compared with no treatment. This figure (called the 'cost–effectiveness plane') presents the incremental effectiveness and costs of oral bisphosphonates compared with no treatment at real-world and full adherence levels. The incremental cost–effectiveness ratio is represented by the slope of the line from the origin. The analysis was conducted in Belgian patients aged 55–85 years either with a bone mineral density T-score ≤-2.5 or a prevalent vertebral fracture at baseline. QALY: Quality-adjusted life-year. Data taken from [4].
Impact of Poor Adherence on Cost–effectiveness
Given that compliance and persistence affect both health outcomes and costs, these concepts should be included to accurately estimate the cost–effectiveness of drug therapies. In our example using observational data (Figure 3), the impact of medication adherence on cost–effectiveness is substantial. The incremental cost per QALY gained of oral bisphosphonates compared with no treatment was estimated at €10,279 and €3909 at real-world and full (assumed) adherence levels, respectively. In this example, poor adherence therefore results in around a doubling of the cost–effectiveness from these medications. It means that for example, with a budget of €20,000, treatment with oral bisphosphonates could save 1.95 life-years in perfect health at real-world adherence levels while, at full adherence, treatment could preserve 5.12 life-years in perfect health. The studies addressing compliance and persistence have shown that both aspects of adherence were important drivers of cost–effectiveness.
(Enlarge Image)
Figure 3.
Impact of medication nonadherence on the cost–effectiveness (expressed as cost in euros per quality-adjusted life-year gained) of oral bisphosphonates compared with no treatment. This figure (called the 'cost–effectiveness plane') presents the incremental effectiveness and costs of oral bisphosphonates compared with no treatment at real-world and full adherence levels. The incremental cost–effectiveness ratio is represented by the slope of the line from the origin. The analysis was conducted in Belgian patients aged 55–85 years either with a bone mineral density T-score ≤-2.5 or a prevalent vertebral fracture at baseline. QALY: Quality-adjusted life-year. Data taken from [4].
Source...