title: Economic evaluation in collaborative hospital drug evaluation reports.
abstract: OBJECTIVE
  economic evaluation is a fundamental criterion when deciding a drug's place in therapy. The MADRE method (Method for Assistance in making Decisions and Writing Drug Evaluation Reports) is widely used for drug evaluation. This method was developed by the GENESIS group of the Spanish Society of Hospital Pharmacy (SEFH), including economic evaluation. We intend to improve the economic aspects of this method. As for the direction to take, we have to first analyze our previous experiences with the current methodology and propose necessary improvements.
  
  
  METHODS
  economic evaluation sections in collaboratively conducted drug evaluation reports (as the scientific society, SEFH) with the MADRE method were reviewed retrospectively.
  
  
  RESULTS
  thirty-two reports were reviewed, 87.5% of them included an economic evaluation conducted by authors and 65.6% contained published economic evaluations. In 90.6% of the reports, a Budget impact analysis was conducted. The cost per life year gained or per Quality Adjusted Life Year gained was present in 14 reports. Twenty-three reports received public comments regarding the need to improve the economic aspect. Main difficulties: low quality evidence in the target population, no comparative studies with a relevant comparator, non-final outcomes evaluated, no quality of life data, no fixed drug price available, dosing uncertainty, and different prices for the same drug.
  
  
  CONCLUSIONS
  proposed improvements: incorporating different forms of aid for non-drug costs, survival estimation and adapting published economic evaluations; establishing criteria for drug price selection, decision-making in conditions of uncertainty and poor quality evidence, dose calculation and cost-effectiveness thresholds depending on different situations.
authors.affiliation: Group for drug evaluation, standardization and research in drug selection (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH). Pharmacy Services, Clínica Universidad de Navarra (Pamplona), Spain.. aortega@unav.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Ortega
authors.affiliation: Group for drug evaluation, standardization and research in drug selection (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH). Pharmacy Services, Hospital General Mancha Centro (Alcázar de San Juan), Spain.. mdfraga@sescam.jccm.es.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Fraga
authors.affiliation: Group for drug evaluation, standardization and research in drug selection (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH). Pharmacy Services, Hospital Universitario de Valme, AGS Sur de Sevilla, Spain.. roberto.marin.sspa@juntadeandalucia.es.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marín-Gil
authors.affiliation: Group for drug evaluation, standardization and research in drug selection (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH). Pharmacy Services, Hospital Universitario y Politécnico La Fe (Valencia), Spain.. lopez_edubri@gva.es.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lopez-Briz
authors.affiliation: Group for drug evaluation, standardization and research in drug selection (GENESIS) of the Spanish Society of Hospital Pharmacy (SEFH). Pharmacy Services, Hospital Universitario Son Espases (Palma de Mallorca), Spain.. fpuigventosl@gmail.com.
authors.forename: Francesc
authors.initials: F
authors.lastname: Puigventós
authors.affiliation: School of Medicine, University of Ioannina, Greece.. george@augmentium.com.
authors.forename: George
authors.initials: G
authors.lastname: Dranitsaris
mesh_terms: D002017:Budgets; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004341:Drug Evaluation / Q000191:economics / Q000592:standards*; D004358:Drug Therapy / Q000191:economics*; D006801:Humans; D004364:Pharmaceutical Preparations / Q000191:economics*; D010607:Pharmacy Service, Hospital / Q000191:economics; D013030:Spain
chemical_list: D004364:Pharmaceutical Preparations