The role of pharmacoeconomic modeling in evidence-based and value-based formulary guidelines.

OBJECTIVE: To review evidence-based medicine (EBM) in the context of pharmacoeconomic (PE) decision making by health care organizations. SUMMARY: Pharmacoeconomics involves processes similar to EBM, but it deals with decisions on the population rather than the patient level. The overall goal of PE is to provide the most efficient use of resources, taking into account both the cost and the value derived from a given technology. These evaluations assist health care decision making because both cost and effectiveness are considered. New therapies are increasingly complex in terms of administration, effects, and cost. As a result, PE models are likely to become more complex as well. At present, there is no standard threshold for what constitutes cost-effective therapy, so each organization is likely to have its own criterion for acceptance. CONCLUSION: Clinical trial results define the safety and efficacy of therapy but cannot determine whether a given technology represents a good buy for a specific organization. This requires PE analysis.