Clinical studies to assess the economic impact of new therapies: pragmatic approaches to measuring costs.

Pragmatic clinical trials using unselected patients in normal clinical situations are more appropriate for the economic assessment of new drugs. However, standard clinical studies that do not reflect current practice are useful and at present the only source of information. Anti-emetic drug studies using granisetron and ondansetron have demonstrated that the overall economic impact of these drugs is equivalent to standard therapies such as metoclopramide. Thus, an efficient anti-emetic drug with less frequent dosing, using a simplified dosage regimen and producing a reduction in anticipatory nausea and vomiting and in nursing time, may result in an overall reduction in cost. Decisions made purely on the basis of drug costs may be misleading and promote inefficient use of health resources.