What is known and objective: Economic evaluation is used to assess the value for money of medicines and inform pharmaceutical pricing/reimbursement decisions in many countries. This paper aims to report on estimates of the value for money of medicines in Europe.
Methods: Estimated cost-utilities were derived from studies included in the Tufts Medical Center Cost-Effectiveness Analysis Registry between 2000 and 2007. For each study, the following variables were examined: publication year, target population, intervention type, country of patient sample, disease classification, prevention stage, funding source, study perspective, discounting, sensitivity analysis, incremental cost-utility ratio (ICUR) and methodological quality.
Results and discussion: Six hundred and eight ICURs were reported in 231 cost-utility analyses. Around 17·1% of ratios related to medicines that were more effective and less expensive than the comparator; 76·5% related to medicines that improved outcomes, but increased costs; and 6·4% related to medicines that were less effective and more expensive than the comparator. The median ratio was 12,238 € per quality-adjusted life year (QALY). Using threshold values of 20,000 and 50,000 € per QALY, the probability that medicines provided value for money was 58% and 81%, respectively. Preventive medicines studied provided more value for money than curative medicines (P=0·002). Studies sponsored by industry generated more favourable results than studies sponsored from other sources (P<0·001). However, no association was observed between the funding source and the methodological quality of economic evaluations.
What is new and conclusion: The evidence base suggests that the majority of medicines provided value for money. Such information informs policy decisions relating to the allocation of scarce health care resources in Europe.
© 2011 Blackwell Publishing Ltd.