Budget Impact Analysis : A Difference between Theory and PracticeC. Sook sriwong*, F. Chanjaruporn
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Budget impact analysis (BIA) has been increasingly considered as one important tool in the evaluation of health economics. At present, many countries require the pharmaceutical industry to submit the BIA study together with pharmacoeconomics evaluation as part of the drug registration or drug listing process. The objective of this study was to compare the difference in the budget impact analysis (BIA) result of pemetrexed calculating based on the theoretical BIA study with the actual result of the empirical study for the treatment of lung cancer. This was a cross-sectional research conducted from a payer’s perspective used a teaching hospital’s database in Bangkok, Thailand during the fiscal years 2005-2009 as the primary data source. Drug costs charged to the patients were included in the analysis. BIA was performed by taking into account the number of eligible patients and costs of drugs for each patient. Total drug expenditure of each patient was calculated and interpreted both in terms of entire cost and cost per patient. The results from the empirical study revealed an increasing trend of total drug expenditure for 17 non-small cell lung cancer (NSCLC) drugs. The average expenditure per patient for most drugs increased over the time. Pemetrexed expenditure rose from $259 to $2,170. In the theoretical BIA study, the hospital had to spend $11,881 for pemetrexed per one patient with NSCLC on average. The total cost of pemetrexed over the four years was $671,816. A difference in the result was clearly observed as the budget impact per patient in the theoretical BIA was constant while that of the empirical study increased over the time. In conclusions, other factors possibly cause an increase in drug expenditure in a BIA study should be taken into account. Evaluation of the hospital’s drug policy should also be performed in order to control rising drug expenditure.
Keyword:
Budget impact analysis, pemetrexed, lung cancer, non-small cell, Thailand
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