Multiple strategy comparisons in health technology assessment (HTA) are becoming increasingly important, with multiple alternative therapeutic actions, combinations of therapies and diagnostic and genetic testing alternatives. Comparison under uncertainty of incremental cost, effects and cost...

Background: Market authorization does not guarantee patient access to any given drug. This is particularly true for costly orphan drugs because access depends primarily on co-payments, reimbursement policies and prices. The objective of this article is to identify differences in the availability...

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of denosumab (Amgen Inc., UK) to submit evidence for the clinical and cost effectiveness of denosumab for the prevention of fragility fractures in post-menopausal women, as part of the Institute's single...

Objective: To describe the pharmacoeconomic assessment process in Ireland and to provide examples of recent appraisals and the subsequent impact on pricing and reimbursement decisions. Method: The pharmacoeconomic appraisals conducted by the National Centre for Pharmacoeconomics (NCPE) between...

Economists engaged in comparative effectiveness research (CER) commonly adopt particular value judgements that underpin many of their methods. Two of these are the idea of a 'societal perspective' and that the foundation of values in measures of health outcome is individual preferences. This...

Health systems that have fixed budgets and a coherent organizational structure generally have found it valuable to have a dedicated primary research capacity to answer decision-oriented value-for-money questions of particular importance to the system. The UK NHS is one example of such a system....

The application of cost-effectiveness analysis in healthcare has become commonplace in the US, but the validity of this approach is in jeopardy unless the proverbial $US50 000 per QALY benchmark for determining value for money is updated for the 21st century. While the initial aim of this...