Starting or Strengthening a Drug Bulletin - A Practical Manual
(2005; 165 pages) View the PDF document
Table of Contents
View the documentPreface
View the documentHow the manual was produced
View the documentAbout ISDB
View the documentExecutive summary
Open this folder and view contents1. Introduction
Open this folder and view contents2. Rational use of medicines
Open this folder and view contents3. What are drug bulletins?
Open this folder and view contents4. Defining aims, target and type of bulletin
Open this folder and view contents5. Planning resources
Open this folder and view contents6. Planning bulletin production: schedules and timing
Open this folder and view contents7. The editorial process
Close this folder8. Reviewing a new drug: is it a therapeutic advance?
View the document8.1 Introduction
View the document8.2 When is a new treatment a therapeutic advance?
Open this folder and view contents8.3 Collecting evidence about the drug
Open this folder and view contents8.4 Evaluation in terms of efficacy, harm and convenience
Open this folder and view contents8.5 Judging the overall value of the drug
Close this folder8.6 Cost
View the document8.6.1 Compare costs in the light of true therapeutic value
View the document8.6.2 Comparisons should be appropriate and practical
View the document8.6.3 Bear in mind additional costs for using drugs
View the document8.7 What patients need to know
View the document8.8 References
Open this folder and view contentsAnnexe to Chapter 8: Evaluating harm
Open this folder and view contents9. Design and production
Open this folder and view contents10. Dissemination
Open this folder and view contents11. Organizational and legal issues
Open this folder and view contents12. Evaluating quality and usefulness
Open this folder and view contents13. Partnership and collaboration
Open this folder and view contents14. Keeping records and creating a memory
Open this folder and view contentsAppendix: Electronic sources of information
 

8.6.1 Compare costs in the light of true therapeutic value

Cost is obviously an important consideration in deciding whether to use a drug. So each evaluation should routinely include a price comparison for the new product and the existing alternatives. However, the influence on the choice of drug should come only when the clinical value (efficacy, safety and convenience) of the product has been established relative to standard therapies.

In general, new classes of drugs are far more expensive than the standard classical drugs. There are many examples of this: antihistamines (sedative versus less sedative); antidepressants (tricyclic versus SSRI), anti-allergics (inhaled steroid versus leukotriene receptor antagonist), antihypertensives (diuretics versus angiotensin receptor inhibitors). But very often, the higher cost is not accompanied by any significant advantage in terms of therapeutic value. And there is always the possibility that a new drug is harmful and less effective but only more expensive than the standard drugs.


Figure 8.1 Comparative price per month of antihypertensive drugs (in Japan)

When several new drugs from the same class (e.g. less-sedative antihistamines, statins, leukotriene receptor antagonists, angiotensin receptor inhibitors) become available (so-called ‘me-toos’), it is often the case that there is little difference between the drugs in the same chemical group.

Costs comparisons can be shown in various ways. Illustrated below are examples of the use of bar charts (Figures 8.1, 8.2 and 8.3) and a table (Table 8.1).

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