title: The economics of medicines optimization: policy developments, remaining challenges and research priorities.
abstract: BACKGROUND
  This review scopes the evidence on the effectiveness and cost-effectiveness of interventions to improve suboptimal use of medicines in order to determine the evidence gaps and help inform research priorities.
  
  
  METHODS
  Systematic searches of the National Health Service (NHS) Economic Evaluation Database, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects.
  
  
  RESULTS
  The majority of the studies evaluated interventions to improve adherence, inappropriate prescribing and prescribing errors.
  
  
  RESULTS
  Interventions tend to be specific to a particular stage of the pathway and/or to a particular disease and have mostly been evaluated for their effect on intermediate or process outcomes.
  
  
  CONCLUSIONS
  Medicines optimization offers an opportunity to improve health outcomes and efficiency of healthcare.
  
  
  CONCLUSIONS
  The available evidence is insufficient to assess the effectiveness and cost-effectiveness of interventions to address suboptimal medicine use in the UK NHS. Decision modelling, evidence synthesis and elicitation have the potential to address the evidence gaps and help prioritize research.
authors.affiliation: Centre for Health Economics, University of York, York, UK rita.nevesdefaria@york.ac.uk.
authors.forename: Rita
authors.initials: R
authors.lastname: Faria
authors.affiliation: Centre for Health Economics, University of York, York, UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Barbieri
authors.affiliation: Centre for Reviews and Disseminations, University of York, York, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Light
authors.affiliation: School of Pharmacy, University of Nottingham, Nottingham, UK.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Elliott
authors.affiliation: Centre for Health Economics, University of York, York, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Sculpher
mesh_terms: D003362:Cost-Benefit Analysis; D011307:Drug Prescriptions / Q000191:economics* / Q000592:standards; D019317:Evidence-Based Medicine / Q000379:methods; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D055118:Medication Adherence; D008508:Medication Errors / Q000517:prevention & control; D011050:Policy Making; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards; D013222:State Medicine / Q000191:economics / Q000592:standards; D006113:United Kingdom
keywords: cost-effectiveness; economics; medicines management; medicines optimization; review