This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Medical Practice  • Health Policy  • Medical Practice, Other  • Quality of Life  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their Commentary on drug prices and value for money, Dr Henry and colleagues¹ contrast ways in which the British National Institute for Clinical Excellence and the Australian Pharmaceutical Benefits Scheme use cost-effectiveness analysis (CEA) to assess the value of medical technologies, including newly approved drugs. They assert that if a drug is cost-effective it should be affordable to the third-party payer, so long as the "cost-effectiveness threshold has been set appropriately." I believe that this is incorrect for 2 reasons.

First, a new drug may have a favorable incremental cost-effectiveness ratio (ICER) yet be considered unaffordable to the third-party payer because of the eligibility of large numbers of patients for the new treatment. Bupropion, orlistat, and sildenafil are examples of drugs that some third-party payers in Europe and the United States have deemed unaffordable despite having generally favorable ICERs.² Cost-effectiveness analysis compares the additional costs and . . . [Full Text of this Article]

Joshua P. Cohen, PhD
joshua.cohen@tufts.edu
Tufts University Center for the Study of Drug Development
Boston, Mass

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Cost-effectiveness and Resource Allocation—Reply
Anthony Harris, Suzanne R. Hill, and David A. Henry
JAMA. 2006;295(23):2723-2724.
EXTRACT | FULL TEXT  

Quality, Innovation, and Value for Money: NICE and the British National Health Service
Steven D. Pearson and Michael D. Rawlins
JAMA. 2005;294(20):2618-2622.
ABSTRACT | FULL TEXT