Role of pharmacoeconomics in developing countries

Abstract

Farmeconomia. Health economics and therapeutic pathways 2013; 14(1): 3-5ROLE OF PHARMACOECONOMICS IN DEVELOPING COUNTRIESMost developing countries lack policies that encourage the use of economic evaluations in medicine selection, be it for public funding, prioritization of aid or health insurance. In addition, relevant guidelines for reporting pharmacoeconomic analyses are not availa-ble in the majority of countries. Most deve-loping countries do have National Essential Medicine Lists to guide procurement and do -nation of medicines in the public sector [5]. However, the extent to which they employ the WHO’s evidence-based approach or other guidelines advocating the use of economic evaluation criteria in drug selection has not been established. Studies conducted by Mori et al. [6] and Gavaza et al. [7-9] in a number of countries in East, South and West Africa have documented a very low availability of pharmacoeconomic studies. Some of these studies were too poor in quality and narrow in scope to be appropriate as evidence to in-form decision-making. A similar trend has also been reported for developing countries in Asia [10-12].Another important observation is that, even when pharmacoeconomic studies are availa-ble, they are not systematically or consistently applied in decision-making [6,13]. Experien-ce shows that many pharmacoeconomic stu-dies were conducted long after the decisions had been made, sometimes simply to justify or disqualify those decisions, but more often for academic purposes. Cost-effectiveness studies of artemisinin-based combination therapies for malaria control, for example, were conducted in a number of countries af-ter the decisions to recommend the treatment in the respective malaria treatment guide-lines had already been made [14-16]. Low availability and inconsistent application of pharmacoeconomic data implies that phar-macoeconomics so far has had a limited role INTRODUCTIONThe high price of medicines and increasing expenditure on pharmaceuticals is a serious concern for governments in low-income countries where already over half of the population lacks regular access to essential medicines [1]. Currently, pharmaceuticals in low-income countries consume 30-60 percent of the recurrent healthcare budgets, yet the unmet need for medicines has been strongly associated with insufficient public spending on pharmaceuticals [2]. Poor fa-milies mostly rely upon public healthcare systems, where shortages of drugs are ram-pant [3]. In this situation the use of pharma -coeconomic principles is inevitable when an objective is to ensure that the limited re-sources are efficiently spent on drug thera-pies with large potentials to improve health. While developing countries commonly use National Essential Medicine Lists to prio-ritize the allocation of scarce public fun-ds between drug therapies, little is known about the role of pharmacoeconomics in such decisions. In this editorial we there-fore examine how pharmacoeconomics has influenced prioritization decisions between drugs in developing countries.WHAT IS PHARMACOECONOMICS?Pharmacoeconomic analysis involves the identification, measurement, valuation and comparison of costs and outcomes of alter-native drug therapies. The underlying aim is to maximize treatment outcomes within limited budgets [4]. Due to the high alterna-tive costs of scarce funds, it may be argued that pharmacoeconomics is relatively more important in developing countries than in developed countries. By alternative costs in this context we mean the health losses from making sub-optimal decisions.