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Pharmacoeconomics and therapeutic drug monitoring.

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Abstract

The ever increasing rate of inflation and the reality that resources for medical care are limited has led to significant changes in the reimbursement for health care services. These influences have convinced health care policy makers to closely evaluate innovative health services in terms of the benefits and costs. New pharmaceutical services must be economically justified in order to exist in the future. This is crucial to the expansion and adoption of pharmaceutical services.

Application of economic evaluations is not new to the health care sector. Until recently, there were no incentives to transfer this interest into widespread use. As health care expenditures have escalated over the past two decades, the number of applications of these techniques has increased. Especially significant are cost‐benefit and cost‐effectiveness evaluations of medical practice, pharmaceuticals, and other health care technologies.

Pharmacoeconomic analysis is an important tool to assist in the evaluation of new pharmaceutical services and technologies. Essentially, economic analytical methods are used to weigh the positive and negative consequences of alternative courses of action. The usefulness of pharmacoeconomic analyses is in resource allocation, with the purpose of achieving the highest return on investment or accomplishing a given objective in the least costly manner. Unfortunately, very few pharmacy programs have been evaluated using pharmacoeconomic techniques. The purpose of this article is to present various methods to assess the economic value of therapeutic drug monitoring services in society and for specific patient populations. Additionally, this article will review the previous attempts and various issues surrounding the economic justification of therapeutic drug monitoring.

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References

  1. Bootman JL, Townsend RJ, McGhan WF. Introduction to phar macoeconomics. In: Bootman JL, Townsend RJ, McGhan WF, eds. Principles of pharmacoeconomics, 2nd ed. Cincinnati, Ohio: Harvey Whitney Books Company, 1996: 4–19.

    Google Scholar 

  2. Drummond MF, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1987.

    Google Scholar 

  3. Eisenberg JM. Clinical economics: a guide to the economic analysis of clinical practices. JAMA 1989; 262: 2879–86.

    Google Scholar 

  4. Harrison DL, Draugalis JR. Pharmacoeconomics: types of studies. In: Health Economics in the USA. IMS America, Plymouth Meeting, PA, 1996: 209–21.

    Google Scholar 

  5. McGhan WF, Rowland CR, Bootman JL. Cost-benefit and cost-effectiveness: methodologies for evaluating innovative pharmaceutical services. Am J Hosp Pharm 1978; 35: 133–40.

    Google Scholar 

  6. Bootman JL, Wertheimer AI, Zaske D, Rowland C. Individualizing gentamicin dosage regimens in burn patients with gram-negative septicemia: a cost-benefit analysis. J Pharm Sci 1979; 68: 267–79.

    Google Scholar 

  7. Townsend R. Post-marketing drug research and development. Ann Pharmacother 1987; 21: 134.

    Google Scholar 

  8. Bootman JL, Townsend RJ, McGhan WF. Principles of pharmacoeconomics, 1st ed. Cincinnati, Ohio: Harvey Whitney Books Company, 1991: 4–19.

    Google Scholar 

  9. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990; 47: 533–43.

    Google Scholar 

  10. Strand LM, Cipolle R, Morley PC. Drug-related problems: their structure and function. DICP 1990; 24: 1093–7.

    Google Scholar 

  11. Manasse HR Jr. Medication use in an imperfect world, I: drug misadventuring as an issue of public policy. Am J Hosp Pharm 1989; 46: 929–44.

    Google Scholar 

  12. Manasse HR Jr. Medication use in an imperfect world, II: drug misadventuring as an issue of public policy. Am J Hosp Pharm 1989; 46: 1141–52.

    Google Scholar 

  13. Johnson JA, Bootman JL. Drug-related morbidity and mortality: a cost-of-illness model. Arch Intern Med 1995; 155: 1949–56.

    Google Scholar 

  14. Sullivan SD, Kreling DH, Hazlet TK. Noncompliance with medication regimens and subsequent hospitalization: a literature analysis and cost of hospitalization estimate. J Res Pharm Econ 1990; 2: 19–33.

    Google Scholar 

  15. Crawford SY, Myers CE. ASHP national survey of hospital based pharmaceutical services. Am J Hosp Pharm 1993; 50: 1371–1404.

    Google Scholar 

  16. Murphy JE, Slack MK, Campbell S. National survey of hospital based pharmacokinetic services. Am J Health-Syst Pharm 1996; 53 (in press).

  17. Vozeh S. Cost-effectiveness of therapeutic drug monitoring. Clinical Pharmacokin 1987; 13: 131–40.

    Google Scholar 

  18. Mackeigan L, Bootman JL. A review of cost-benefit and cost-effectiveness of clinical pharmacy services. J Pharmaceut Marketing and Management, 1899; 2: 63–84.

    Google Scholar 

  19. Moore RD, Smith CR, Lietman PS. Association of aminoglycoside levels with therapeutic outcome in gram negative pneumonia. Am J Med 1984; 77: 657–62.

    Google Scholar 

  20. Elenbaas RM, Payne VW, Bootman JL et al. Demand for blood level testing service in an ambulatory geriatric population. J Am Ger Soc 1989; 3: 109–23.

    Google Scholar 

  21. Crist KD, Nahta MC, Ety J. Positive impact of a therapeutic drug-monitoring program on total aminoglycoside dose and cost of hospitalization. Ther Drug Monit 1987; 9: 306–10.

    Google Scholar 

  22. Destache CJ, Meyer SM, Padomek MJ, Ortmeier BG. Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides for gram-negative infections. Ann Pharmacother 1989; 23: 33–8.

    Google Scholar 

  23. Kimelblatt BJ, Bradbury K, Chodoff L, Aggour T, Mehl B. Cost-benefit analysis of an aminoglycoside monitoring service. Am J Hosp Pharm 1986; 43: 1205–9.

    Google Scholar 

  24. Smith M, Murphy JE, Job ML, Ward ES. Aminoglycoside monitoring: use of a pharmacokinetic service versus physician recommendations. Hosp Formul 1987; 22: 92–102.

    Google Scholar 

  25. Sveska KJ, Roffe BD, Solomon DK, Hoffman RP. Outcome of patients treated by an aminoglycoside pharmacokinetic dosing service. Am J Hosp Pharm 1985; 42: 2472–7.

    Google Scholar 

  26. Burton ME, Ash CL, Hill DP, Handy T, Shepherd MD, Vasko MR. A controlled trial of the cost-benefit of a computerized bayesian aminoglycoside administration. Clin Pharmacol Ther 1991; 49: 685–94.

    Google Scholar 

  27. Destache CJ, Meyer SM, Bittner MJ, Hermann KG. Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides: a cost-benefit analysis. Ther Drug Monit 1990a; 12: 419–26.

    Google Scholar 

  28. Destache CJ, Meyer SM, Bittner MJ, Hermann KG. Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides: a cost-benefit analysis. Ther Drug Monit 1990b; 12: 427–33.

    Google Scholar 

  29. Eisenberg JM, Koffer H, Glick HA, Counell ML, Loss LE et al. What is the cost of nephrotoxicity associated with aminoglycosides? Ann Intern Med 1987; 107: 900–9.

    Google Scholar 

  30. Bertino JS Jr, Booker LA, Franck PA, Jenkins PL, Franck XR et al. Incidence of and significant risk factors for aminoglycosideassociated nephrotoxicity in patients dosed by using individualized pharmacokinetic monitoring. J Infect Dis 1993; 167: 1739.

    Google Scholar 

  31. Einarson T, McGhan WF, Bootman JL, Larson LN, Gardner ME, Kligman EW. Demand for blood level testing service in an ambulatory geriatric population. J Am Ger Soc 1989; 3: 109–23.

    Google Scholar 

  32. Wade WE, McCall CY. Educational effort and CQI program improves ordering of serum digoxin levels. Hosp Formul 1994; 72: 567–73.

    Google Scholar 

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Authors and Affiliations

  1. College of Pharmacy, The University of Arizona, PO Box 210207, Tucson, Arizona, 85721-0207, U.S.A

    J. Lyle Bootman (Professor and Dean)

  2. Clinical Investigation Regulatory Office, ATTN: MCCS-GCI, MAJ, US Army, 1608 Stanley Road, Building 2268, Ft. Sam Houston, Texas, 78234-6125, U.S.A

    Donald L. Harrison

Authors
  1. J. Lyle Bootman
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Lyle Bootman, J., Harrison, D.L. Pharmacoeconomics and therapeutic drug monitoring.. Pharm World Sci 19, 178–181 (1997). https://doi.org/10.1023/A:1008634318875

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