Читать книгу Clinical Pharmacology and Therapeutics - Группа авторов - Страница 151

Pharmacoeconomics and cost‐effectiveness assessment alone do not lead to decisions about which drug interventions a healthcare system should use. The economic assessment provides a structured, objective method to compare the costs and benefits of different possible interventions, but this may only be part of the decision‐making process. While an approach based purely on economic assessment might offer the greatest efficiency in a healthcare system, other factors, such as a desire to see equality of access to treatments or a desire to favour specific patients groups (e.g. children, or patients nearing the end of their life), may lead decision makers to adopt treatments with ICERs above the normal threshold (or reject treatments with ICERs below the normal threshold).

These difficult issues are ultimately matters of judgement rather than calculation, but the economic assessment at least provides useful background to the decision and reveals the extent to which efficiency is being sacrificed to the specific wishes of the healthcare system. While pharmacoeconomics clearly has its limitations, it offers the best available approach to underpinning the difficult decisions which scarcity and choice demand in increasingly cash‐limited healthcare systems worldwide.