Comparing jurisdiction-specific pharmaco-economic evaluations using medical purchasing power parities

J Med Econ. 2021 Nov;24(sup1):34-41. doi: 10.1080/13696998.2021.2007705.

Abstract

Objectives: To demonstrate how medical purchasing power parities (mPPP) may harmonize economic evaluations from different jurisdictions and enable comparisons across jurisdictions.

Methods: We describe the use of mPPPs and illustrate this with an example of economic evaluations of nab-paclitaxel with gemcitabine (Nab-P + Gem) versus gemcitabine monotherapy in the setting of metastatic pancreatic cancer. Following a literature search, we extracted data from cost-effectiveness studies on these treatments performed in various countries. mPPPs from the Organization for Economic Co-operation and Development were used to convert reported costs in the jurisdiction of origins to US dollars for the most current year using two possible pathways: (1) reported costs first adjusted by mPPP then adjusted by exchange index; and (2) reported costs first adjusted by exchange index then adjusted by mPPP.

Results: Despite many of the pharmaco-economic evaluations sharing similar assumptions and inputs, even after mPPP conversion, residual heterogeneity was attributable to perspectives, discount rate, outcomes, and costs, among others; including in studies conducted in the same jurisdiction.

Conclusion: Despite the methodological challenges and heterogeneity within and across jurisdictions, we demonstrated that mPPP offers a way to compare economic evaluations across jurisdictions.

Keywords: I; I1; I10; I11; I15; Pharmaco-economic evaluation comparison; cost-effectiveness comparison; gemcitabine monotherapy; healthcare purchasing power parities; medical purchasing power parities; metastatic pancreatic cancer; nab-paclitaxel with gemcitabine.

MeSH terms

  • Cost-Benefit Analysis
  • Humans
  • Pancreatic Neoplasms*