ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2018
A Transparent and Consistent Approach to Assess US Outpatient Drug Costs for Use in Cost-Effectiveness Analyses.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed.
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- Cost-Effectiveness Analysis Methods Used in Evaluations of Treatment for Cystic Fibrosis: A Scoping Review.PharmacoEconomics · 2025Article
- Cost-effectiveness of long-acting cabotegravir/rilpivirine for people with HIV and adherence challenges at the Ward 86 clinic: an intermediate outcome analysis.AIDS (London, England) · 2025Article
- Identifying characteristics for a cost-effective psoriatic arthritis biomarker test: a development-focused health technology assessment.International journal of technology assessment in health care · 2025Article
- Cost of Cardiovascular Disease Event and Cardiovascular Disease Treatment-Related Complication Hospitalizations in the United States.Circulation. Cardiovascular quality and outcomes · 2024Article
- DapagliflozinFrontiers in pharmacology · 2024Article
- Cost-effectiveness analysis of initial treatment with single-pill combination antihypertensive medications.Journal of human hypertension · 2023Article
- Cost-Effectiveness of Sequential Abaloparatide/Alendronate in Men at High Risk of Fractures in the United States.PharmacoEconomics · 2023Article
- Effect of Dapagliflozin Versus Empagliflozin on Cardiovascular Death in Patients with Heart Failure Across the Spectrum of Ejection Fraction: Cost per Outcome Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023Article
- Cost-Effectiveness Analysis of Six Immunotherapy-Based Regimens and Sunitinib in Metastatic Renal Cell Carcinoma: A Public Payer Perspective.JCO oncology practice · 2023Article
- Dapagliflozin versus empagliflozin in patients with chronic kidney disease.Frontiers in pharmacology · 2023Article
- Comparison of US and EU Prices for Orphan Drugs in the Perspective of the Considered US Orphan Drugs Act Modifications and Discussed Price-Regulation Mechanisms Adjustments in US and European Union.International journal of environmental research and public health · 2022Article
- Cost-Effectiveness of Tumor Genomic Profiling to Guide First-Line Targeted Therapy Selection in Patients With Metastatic Lung Adenocarcinoma.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022Article
- Drug costs in context: assessing drug costs in cost-of-illness analyses.Drugs in context · 2022Article
- Cost-effectiveness of Dapagliflozin for Treatment of Patients With Heart Failure With Reduced Ejection Fraction.JAMA cardiology · 2021Article
- Industry Payments to Physicians and Prescribing Branded Memantine and Donepezil Combination.Neurology. Clinical practice · 2021Article
- Association of Drug Rebates and Competition With Out-of-Pocket Coinsurance in Medicare Part D, 2014 to 2018.JAMA network open · 2021Article
- Cost-Effectiveness of Esketamine Nasal Spray for Patients With Treatment-Resistant Depression in the United States.Psychiatric services (Washington, D.C.) · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundAssessment of drug costs for cost-effectiveness analyses (CEAs) in the United States is not straightforward because the prices paid for drugs are not publicly available and differ between payers. CEAs have relied on list prices that do not reflect the rebates and discounts known to be associated with these purchases.
objectivesTo review available cost measures and propose a novel strategy that is transparent, consistent, and applicable to all CEAs taking a US health care sector perspective or a societal payer's perspective.
methodsWe propose using the National Average Drug Acquisition Cost (NADAC), the Veterans Affairs Federal Supply Schedule (VAFSS), and their midpoint as the upper bound, lower bound, and base case, respectively, to estimate net drug prices for various payers. We compare this approach with wholesale acquisition cost (WAC), the most common measure observed in our literature review. The minimum WAC is used to provide the most conservative comparison.
resultsOur sample consists of 1436 brand drugs and 1599 generic drugs. On average, the upper bound (NADAC) is 1% and 9.8% lower than the WAC for brand and generic drugs respectively, whereas the lower bound (VAFSS) is 48.3% and 54.2% lower than the WAC. The NADAC is less than the WAC in 89.6% of drug groups. The distributions of these relationships do not show a clear mode and have wide variation.
conclusionsOur study suggests that the WAC may be an overestimate for the base case because the minimum WAC is higher than the NADAC for most drugs. Our approach balances uncertainty and lack of data for the cost of pharmaceuticals with the need for a transparent and consistent approach for valid CEAs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.