PMU1 MEASUREMENT HEALTH OUTCOMES ASSOCIATED WITH MEDICINES AT A NATIONAL LEVEL

Abstract

Discussion on medicines provision at a national level focuses on overall expenditure and cost-containment measures. Expenditure is a critical metric and every healthcare system has a finite budget. However, measurement of alternative indicators can provide a method to benchmark or improve medicines provision. This research examined the practicality of providing national level estimates of the following health outcomes metrics for Ireland; number of patients treated, Quality Adjusted Life Year (QALY) gain and Life Year Gain (LYG). A pilot study was undertaken using the top 10 medicine by total drug expenditure in the Pfizer product portfolio in Ireland for 2017. This information was obtained from a supply database maintained by IQVIA (formerly IMS Health). The quantities of Pfizer medicines supplied were translated into a patient number estimate based on the primary licensed indication and approved posology. The number of patients treated was then matched with LYG and QALY gains associated with the treatment the primary indication for each medicine. Previously published economic evaluation and HTA reports provided required QALY and LYG input data. An estimate of the number of patients treated was available for all 10 medicines examined. QALY estimates were possible for 9 agents. LYG outcomes were non-quantifiable for 7 of the medicines examined. Health outcomes measurements were most difficult to provide for medicines categorised as anti-infectives. Patients treated and QALY were viable outcomes to measure. Application of this type of assessment could provide a useful method to examine the implications of payer interventions and national level drugs policy. The methods described are not without limitation and development of patient electronic healthcare records together with utilisation data would reduce the assumptions around adherence and duration of treatment required for calculations.