Guidelines for performing a pharmacoeconomic analysis.

The fundamentals of pharmacoeconomics are presented. Pharmacoeconomic research is used to identify, measure, and compare the costs, risks, and benefits of programs, services, or therapies and determine which alternative produces the best health outcome for the resources invested. Each pharmacoeconomic method measures costs in monetary terms; the differences lie in the valuation of outcomes. In cost-minimization analysis, the outcomes are considered to be equal and therefore are not measured. Cost-benefit analysis measures outcomes in dollars, whereas cost-effectiveness analysis measures outcomes in nonmonetary units. In cost-utility analysis, outcomes expressed in nonmonetary units are adjusted for health-related quality of life. A well-designed pharmacoeconomic analysis involves 10 steps: (1) defining the problem, (2) determining the study's perspective, (3) determining the alternatives and outcomes, (4) selecting the appropriate pharmacoeconomic method, (5) placing monetary values on the outcomes, (6) identifying study resources, (7) establishing the probabilities of the outcomes, (8) applying decision analysis, (9) discounting costs or performing a sensitivity or incremental cost analysis, and (10) presenting the results, along with any limitations of the study. By adhering to the analytic steps described, the pharmacist undertaking a pharmacoeconomic evaluation has the greatest likelihood of obtaining valid and useful results.