Abstract
The first edition of the Guidelines for Economic Evaluation of Pharmaceuticals: Canada was published in November 1994. At that time, the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) was assigned the task of maintaining and regularly updating the Canadian Guidelines.
Since their introduction, a great deal of experience has been gained with the practical application of the guidelines. Their role has also evolved over time, from being a framework for pharmacoeconomic research to the point where a wide variety of decision-makers use economic evaluations based on the principles set out in the guidelines as a means of facilitating their formulary decisions. In addition, methodologies in certain areas (and the body of related research literature in general) have developed considerably over time. Given these changes in the science and the experience gained, CCOHTA convened a multi-disciplinary committee to address the need for revisions to the guidelines. The underlying principles of the review process were to keep the guidance nature of the document, to focus on the needs of ‘doers’ (so as to meet the information needs of ‘users’) and to provide information and advice in areas of controversy, with sound direction in areas of general agreement.
The purpose of this review is three-fold: (i) to outline the process which lead to the revision of the Canadian Guidelines; (ii) to describe the major changes made to the second edition of this document; and (iii) to consider the ‘next steps’ as they relate to the impact of such guidelines and the measurement of outcomes related to economic assessments of pharmaceuticals in general.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Torrance GW, Blaker D, Detsky A, et al. Canadian guidelines for economic evaluation of pharmaceuticals. Pharmacoeconomics 1996; 9 (6): 535–59
Schubert F, editor. Proceedings: Canadian Collaborative Workshop on Pharmacoeconomics. Le Chantecler, Sainte-Adèle, Québec. Princeton: Excerpta Medica Inc., 1993
Canadian Coordinating Office for Health Technology Assessment (CCOHTA). Guidelines for economic evaluation of pharmaceuticals: Canada. Ottawa: CCOHTA, 1994
Ontario Ministry of Health. Ontario guidelines for economic analysis of pharmaceutical products. Toronto: Ontario Ministry of Health, 1994
Oxman AD. Preparing and maintaining systematic reviews [CD-ROM]. In: Sackett D, Oxman A, editors. The Cochrane Collaboration Handbook. Oxford, UK: The Cochrane Collaboration, 1996
Torrance GW, Seigel JE, Luce BR. Framing and designing the cost-effectiveness analysis. In: Gold MR, Seigel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996: 54–81
Yusuf S, Wittes J, Probstfield J, et al. Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. JAMA 1991; 266 (1): 93–8
Luce BR, Manning WG, Seigel KE, et al. Estimating costs in cost-effectiveness analysis. In: Gold MR, Seigel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996: 176–213
Siegel JE, Torrance GW, Russell LB, et al. Guidelines for pharmacoeconomic studies: recommendations from the Panel on Cost Effectiveness in Health and Medicine. Pharmacoeconomics 1997; 11 (2): 159–68
Canadian Coordinating Office for Health Technology Assessment (CCOHTA). A guidance document for the costing process–Version 1.0. Ottawa: CCOHTA, 1996
Manning WG, Fryback DG, Weinstein MC. Reflecting uncertainty in cost-effectiveness analysis. In: Gold MR, Seigel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996: 247–75
Willan AR, O’Brien BJ. Confidence intervals for cost-effectiveness ratios: an application of Fieller’s theorem. Health Econ 1996; 5 (4): 297–305
Power EJ, Eisenberg JM. Are we ready to use cost-effectiveness analysis in health care decision-making? A health services research challenge for clinicians, patients, health care systems, and public policy. Med Care 1998; 36 (5): MS10–7
Khushf G. A radical rupture in the paradigm of modern medicine: conflicts of interest, fiduciary obligations, and the scientific ideal. J Med Phil 1998; 23 (1): 98–122
Fuchs VR. Ethics and economics: antagonists or allies in making health policy? West J Med 1998; 168 (3): 213–6
Maynard A. Ethical issues in the economics of rationing healthcare. Br J Urol 1995; 76 (2 Suppl.): 59–64
Alban A, Gyldmark M, Vesth Pedersen A, et al. The Danish approach to standards for economic evaluation methodologies. Pharmacoeconomics 1997; 12 (6): 627–36
Commonwealth Department of Human Services and Health. Guidelines for the pharmaceutical industry on preparation of submissions to the Pharmaceutical Benefits Advisory Committee including major submissions involving economic analysis. Canberra: Australian Government Publishing Service, 1995 Nov
Hailey D. Australian economic evaluation and government decisions on pharmaceuticals, compared to assessment of other health technologies. Soc Sci Med 1997; 45 (4): 563–81
Henry D. Workshop: how do agencies actually use health technology data in decision making [panel session #4]. Meeting of the International Society of Technology Assessment in Health Care; 1998 Jun 7-10; Ottawa, 29
Johannesson M. Economic evaluation of drugs and its potential uses in policy making. PharmacoEconomics 1995; 8 (3): 190–8
Langley PC. Pharmacoeconomics and the quality of decision-making by pharmacy and therapeutics committees. Am J Health Syst Pharm 1995; 52 (3 Suppl.): S24–6
Finder S. Providing cost-effective therapy using pharmacoeconomic evaluations: the public sector approach. Clin Ther 1997; 19 (1): 160–6
Lyles A, Luce BR, Rentz AM. Managed care pharmacy, socio-economic assessments and drug adoption decisions. Soc Sci Med 1997; 45 (4): 511–20
Australian National Audit Office. Summary of audit report No. 12 of 1997-98, The Pharmaceutical Benefits Scheme in The Department of Health and Family Services. Commonwealth of Australia: Audit Report No. 12 1997-98. 1997 Nov 17
Reinhardt UE. Making economic evaluations respectable. Soc Sci Med 1997; 45 (4): 555–62
Anis AH, Rahman T, Schechter MT. Using pharmacoeconomic analysis to make drug insurance coverage decisions. Pharmacoeconomics 1998; 13 (1 Pt 2): 119–26
Baladi JF, Menon D, Otten N. Use of economic evaluation guidelines–2 years’ experience in Canada. Health Econ 1998; 7: 221–7
Drummond M. The emerging government requirement for economic evaluation of pharmaceuticals. Pharmacoeconomics 1994; 6 (1 Suppl.): 42–50
Grobler MP, Macarounas-Kirchmann K, Pearce GA, et al. Industry comment on the 1995 Revised Australian Pharmacoeconomic Guidelines. Pharmacoeconomics 1996; 9 (4): 353–6
Langley PC. The November 1995 revised Australian guidelines for the economic evaluation of pharmaceuticals. Pharmacoeconomics 1996; 9 (4): 341–52
Else BA, Cox ER, Armstrong EP. Data sources for pharmacoeconomic and health services research. Am J Health Syst Pharm 1997; 54 (22): 2601–8
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Glennie, D.J.L., Torrance, G.W., Baladi, J.F. et al. The Revised Canadian Guidelines for the Economic Evaluation of Pharmaceuticals. Pharmacoeconomics 15, 459–468 (1999). https://doi.org/10.2165/00019053-199915050-00004
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-199915050-00004