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- W2101478831 abstract "Budget impact analysis (BIA) should be used alongside cost-effectiveness analysis (CEA) to inform formulary decision-making. In the present analysis, US-published BIAs of pharmacological interventions were analyzed to assess trends in reported outcomes and conclusions. Systematic searches (01/2002–12/2012) of PubMed and other sources (i.e., ISPOR/AMCP proceedings, manual reference search) were conducted to identify published BIAs reporting per-member per-month costs (PMPMC or equivalent) associated with the introduction of new pharmacotherapies. The outcome measures (PMPMC and BIA-author judgments of their own results) were analyzed descriptively. Associations between these two measures and other study characteristics (publication year and type, analytical horizon, and patient population size) were evaluated. Fifty BIAs were identified (40% via PubMed), reporting a total of 82 PMPMC outcome estimates (as some studies reported multiple populations/indications). Half were published in/after 2009. The median (min; max) PMPMC across all 82 estimates was 2 (-66; 894) cents (US$). Thirteen percent of all estimates were cost-saving while 75% and 95% were ≤5 and ≤90 cents, respectively. 65% of studies reported results between −5 and +5 cents PMPM. No study characteristics were associated with PMPMC. In 84% of studies the authors provided qualitative judgments of the acceptability of their BIA results. In 6% of studies and estimates, the PMPMC was reported as unacceptable. BIA results cluster within a narrow range (-5 to +5 cents) and are nearly always reported as acceptable. These findings raise questions regarding the relevance and validity of published BIAs. In part, BIAs expressed in PMPMC (particularly in cents on the dollar) may easily provide a false impression of minimal impact. Whether BIA authors should self-judge the acceptability of PMPMC estimates is questionable. Without pre-defined benchmarks, judgments regarding BIA acceptability may be best left to decision-makers and within the context of more comprehensive assessment (including notably CEA results)." @default.
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- W2101478831 date "2013-05-01" @default.
- W2101478831 modified "2023-09-25" @default.
- W2101478831 title "Published Budget Impact Analyses In The United States: Are They (MIS)Informing Decision Makers?" @default.
- W2101478831 doi "https://doi.org/10.1016/j.jval.2013.03.1305" @default.
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