PharmacoEconomics
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As novel treatments for type II diabetes enter the market, there is a need to assess their long-term clinical and economic outcomes against currently available treatment alternatives. Objective compilation and evaluation of current pharmacoeconomic evidence can assist payers and decision makers in determining the appropriate place in therapy of a new medication. ⋯ The current literature presents liraglutide as a cost-effective adjunct treatment for type II diabetes that may also be associated with a reduction in diabetes-related complication costs; however, ICER values are largely dependent on assumptions regarding the benefits of long-term liraglutide treatment and the time horizon of the analysis. Real-world use may make liraglutide unattractive from a payer and policy-maker perspective.
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The UK's National Institute for Health and Care Excellence (NICE) recently proposed amendments to its methods for the appraisal of health technologies. Previous amendments in 2009 and 2011 placed a greater value on the health of patients at the "end of life" and in cases where "treatment effects are both substantial in restoring health and sustained over a very long period". Drawing lessons from these previous amendments, we critically appraise NICE's proposals. ⋯ Furthermore, this baseline threshold is higher than current estimates of the opportunity cost. NICE's proposed threshold range is too high, for empirical and methodological reasons. NICE's proposals will harm the health of unidentifiable patients, whilst privileging the identifiable beneficiaries of new health technologies.
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Historical Article
Ahead of its time? Reflecting on New Zealand's Pharmac following its 20th anniversary.
New Zealand's Pharmaceutical Management Agency (Pharmac) was created in 1993. Unusual in international terms, Pharmac's objective is to work within a fixed budget while ensuring the New Zealand public receives an adequate range of government-subsidised medicines. Following its 20th anniversary, this article reflects on Pharmac's development and role within the New Zealand health system, various changes over time to the agency's scope and activities, its performance and its present challenges.