A Survey of Pharmacoeconomic Research in the United States
APOR NEWS Vol. 2, No. 4 (September-October 1996)
by Marc L. Watrous, PhD1, Josephine Li2 PhD Candidate, Gregory Hess, MD, MBA1, Marilyn Dix Smith, PhD3
The Association for Pharmacoeconomics and Outcomes Research (APOR), the University of South Carolina College of Pharmacy, and SmithKline Beecham Pharmaceuticals recently collaborated on a study designed to assess the current status of pharmacoeconomic research (PER) in the United States. The objectives of the study were to identify (a) respondent's experience with PER; (b) applications and methods of PER and quality of life assessment considered most appropriate and valuable; (c) perceived barriers to expertise in PER.
The sampling frame for the study was defined by a national mailing list held by the Association for Pharmacoeconomics and Outcomes Research (APOR). A seventeen-item mail questionnaire was developed and used for data collection. The questionnaire was developed based on a review of the literature and issues of interest to the researchers conducting the study. In early November 1995, a questionnaire was sent with a cover letter explaining the purpose of the study and a postage-paid envelope to the 2,373 individuals identified from the APOR mailing list. Responses were accepted through December 31, 1995, and respondents were categorized into subgroups based on self-reported practice settings for subsequent analyses. Statistical analyses were conducted using SAS Version 6.08 Software. Descriptive statistics were performed on all categorical data and analysis of variance (ANOVA) techniques were used to test for differences between respondent self-reported practice setting.
A useable response rate of 18.9% (450/2373) was achieved. The sample consisted of those respondents practicing in the categories of academia (31%), consulting (10.3%), government (3.7%), managed care (5.0%), medical institution/clinic (16.2%), pharmacy benefit management (4.6%), and pharmaceutical industry (23.6%).
The majority of respondents indicated that they both participated in (70.9%) and utilized (78.5%) PER and had been doing so for 1-3 years. A greater percentage of from an Academic setting indicated having spent more years of experience as in conducting and utilizing PER compared to the other major practice groups. In terms of training, respondents indicated on-the-job training and workshops to be the most prevalent sources.
Table 1 and 2 displays the means and standard deviations of the respondents' scores for several scaled items. In general, respondents indicated that trends in the US health care environment were increasing the need for PER as well as increasing the value of research on patient preferences, satisfaction, and quality of life. However, several of the major practice groups differed in how they perceived the usefulness of pharmacoeconomic information for specific applications. For applications in product reimbursement as well as development of treatment guidelines/protocols, those in industry perceived the usefulness of pharmacoeconomic information to be higher than did those in medical institutions/clinics. For application in the drug approval process, those in Industry also perceived the usefulness of pharmacoeconomic information to be higher than did those in managed care, medical institutions/clinics, or academia. For applications in pricing and disease state management, respondents from all of the self-reported practice settings perceived pharmacoeconomic self-reporting nature of the questionnaire. Another limitation is the use of a convenience sample rather than one drawn from a random sample. However, the purpose of this study was to determine differences and similarities in how various practice settings regarded the current status of PER and therefore, the sample chosen provided a relatively broad range of practice settings which were likely to be involved with PER.
Useful information concerning the status of PER among various practice settings can be derived from this study. The results of this descriptive study show the need for PER continues to be high and that the usefulness of pharmacoeconomic research for specific applications can vary dependent on practice setting and the stage of development under which the data is being collected and analyses. Finally, the results indicate that there is a clear need for more trained experts in applied PER and better quality data.
1 SmithKline Beecham Pharmaceuticals, Collegeville, PA 2 University of Oklahoma College of Pharmacy, Oklahoma City, OK 3 Association for Pharmacoeconomics and Outcomes Research