Published Jan 2010
Citation
Mansley EC, Carroll NV, Chen KS, et al. Good research practices for measuring drug costs in cost-effectiveness analyses: a managed care perspective: the ISPOR Drug Cost Task Force Report-part III. Value Health. 2010;13(1):14-17.
Abstract
Objectives: The objective of this report is to provide guidance and recommendations
on how drug costs should be measured for costeffectiveness
analyses conducted from the perspective of a managed care
organization (MCO).
M
ethods: The International Society for Pharmacoeconomics and Outcomes
Research (ISPOR) Task Force on Good Research Practices—Use of
Drug Costs for Cost Effectiveness Analysis (DCTF) was appointed by the
ISPOR Board of Directors. Members were experienced developers or users
of CEA models. The DCTF met to develop core assumptions and an
outline before preparing a draft report. They solicited comments on drafts
from external reviewers and from the ISPOR membership at ISPOR meetings
and via the ISPOR Web site.
Results: The cost of a drug to an MCO equals the amount it pays to
the dispenser for the drug’s ingredient cost and dispensing fee minus the
patient copay and any rebates paid by the drug’s manufacturer. The
amount that an MCO reimburses for each of these components can differ
substantially across a number of factors that include type of drug (single
vs. multisource), dispensing site (retail vs. mail order), and site of administration
(self-administered vs. physician’s office). Accurately estimating
the value of cost components is difficult because they are determined by
proprietary and confidential contracts.
Conclusion: Estimates of drug cost from the MCO perspective should
include amounts paid for medication ingredients and dispensing fees, and
net out copays, rebates, and other drug price reductions. Because of the
evolving nature of drug pricing, ISPOR should publish a Web site where
current DCTF costing recommendations are updated as new information
becomes available.
Keywords: costs, cost-effectiveness analysis, drug costs, economic analysis,
managed care.
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Reports
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: Medicare, Medicaid and US Government Payers Perspectives ISPOR drug cost task force report - Part IV
- Good Research Practices for Measuring Drug Costs in Cost Effectiveness Analyses: An Industry Perspective - ISPOR drug cost task force report - Part V
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: An International Perspective - ISPOR drug cost task force report - Part VI
- Good Research Practices for Measuring Drug Costs in Cost Effectiveness Analyses: Issues and Recommendations - ISPOR drug cost task force report - Part I
- Good Research Practices for Measuring Drug Costs in Cost-Effectiveness Analyses: A Societal Perspective - ISPOR drug cost task force report - Part II
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