Economic Evaluation of Drugs in Peripheral Vascular Disease and Stroke

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Increased pressures on health-care budgets mean that governments require good value for money from the resources devoted to health care. In many countries, measures have been introduced to increase efficiency or to contain health-care costs. These include piece controls, limitations on reimbursement of health technologies, budgetary reform in health-care institutions, and the encouragement of competition. Given this changing environment, it is important that drugs and other health technologies be shown to give good value for money. The methods of economic evaluation, such as cost-benefit and cost-effectiveness analysis, can be used to assess the value of drugs and other health technologies. They have been widely applied. The economic evaluation of drugs in peripheral vascular disease and stroke would compare the cost of adding the drug with its benefits. These would include improvements in length and quality of life and the savings in treating vascular events that may be postponed, or lessened in intensity, by effective drug therapy. One study, following a clinical trial of naftidrofuryl in stroke, suggested that there would be significant reductions in costs through reductions in hospital stay if recovery was aided. Further research and a large multicenter trial are under way to confirm these findings. In peripheral artery disease there are no economic data collected alongside clinical trials. It is known, however, that the costs of leg ischemia can be significant. A study in the U.K. found that arterial construction would cost around £7,750 per person (1989 prices) and amputation around £11,000 per person. Therefore, the costs of drug therapy need to be balanced against the costs of treating progressive disease and the consequent reductions in quality of life for the patient.

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