Journal of managed care & specialty pharmacy
-
J Manag Care Spec Pharm · Feb 2015
Comparative StudyCost-effectiveness analysis of allopurinol versus febuxostat in chronic gout patients: a U.S. payer perspective.
Gout is a chronic inflammatory condition associated with poor urate metabolism. Xanthine oxidase inhibitors such as allopurinol and febuxostat are recommended to reduce uric acid levels and to prevent gout attacks in adult patients. Under budget-driven constraints, health care payers are faced with the broader challenge of assessing the economic value of these agents for formulary placement. However, the economic value of allopurinol versus febuxostat has not be assessed in patients with gout over a 5-year time period in the United States. ⋯ Febuxostat was found to be a cost-effective option compared with allopurinol based on a U.S. payer perspective.
-
J Manag Care Spec Pharm · Feb 2015
Evaluation of quality indicators for Dutch community pharmacies using a comprehensive assessment framework.
In 2008, the Dutch Health Care Transparency Programme (Zichtbare Zorg) was set up to develop and apply quality indicators (QIs) for health care. These QIs serve a range of purposes and can be categorized into those for internal use--for meeting quality standards and to continuously measure improvement (formative)--and external use--to enable patients and health insurance companies to distinguish between health care providers (summative). In order to assess the validity of QIs, a comprehensive Indicator Assessment Framework (IAF) was developed. This framework specifies the following criteria for validation: content validity, absence of selection bias, absence of measurement bias, and statistical reliability. Because of the intended summative use, the IAF was used for structural assessment of the QIs set for Dutch community pharmacists. ⋯ When subjecting the QI set for community pharmacies to the requirements of the IAF, only a quarter of the QIs met all requirements. To increase the number of valid process and outcome indicators, meaningful aspects for the outcome of pharmaceutical care have to be defined, and uniform measurement of relevant processes has to be implemented.