Pharmacy World and Science

, Volume 27, Issue 5, pp 364–370 | Cite as

Adherence of Pharmacoeconomic Studies to National Guidelines in the Netherlands

  • Jarir Atthobari
  • Jasper M. Bos
  • Cornelis Boersma
  • Jacobus R. B. J. Brouwers
  • Lolkje T. W. de Jong-van den Berg
  • Maarten J. PostmaEmail author
Review Article


Objective: This study examines the adherence of Dutch pharmacoeconomic studies to the national guidelines of conducting a pharmacoeconomic evaluation.

Methods: Dutch guidelines for pharmacoeconomic research were issued in 1999. All Dutch pharmacoeconomic studies that were published in English during 2000–2002 were selected for our review. Two reviewers examined each study for relevance and compared each study with the nine methodological guidelines selected.

Results: It was found that 29 studies satisfied the inclusion criteria. The societal perspective was taken in 13 out of the 29 studies (45%), an adequate time period of analysis was chosen in 21 (72%), effectiveness was explicitly differentiated from efficacy in 17 (59%), an incremental analysis was performed in 23 (79%), costs, benefits and health gains were discounted in 24 (83%), effectiveness was expressed in LYGs or QALYs in 16 (55%), reference prices were used in 8 (28%), subgroup analysis was presented in 13 (45%) and sensitivity analysis was included in 26 (90%).

Conclusions: In this review we found that the adherence of studies to some of the Dutch guidelines for pharmacoeconomic studies is fair. However, major improvements are required with respect to the adoption of the societal perspective, presentation of adequate subgroup analyses and application of reference prices.

Key words

Adherence to guidelines Guidelines Pharmacoeconomics Review The Netherlands 


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  1. 1.
    Delwel, GO, Sprenger, MJ 2002Pharmacoeconomic evaluations of new drugs: potential key to a more efficient allocation of the health care budgetNed Tijdschr Geneeskd146106871(in Dutch)PubMedGoogle Scholar
  2. 2.
    Hjelmgren, J, Berggren, F, Andersson, F 2001Health economic guidelines: similarities, differences and some implicationsValue Health422550CrossRefPubMedGoogle Scholar
  3. 3.
    College voor zorgverzekeringen (Health Care Insurance Board)1999Richtlijnen voor farmaco-economisch onderzoek. (Dutch guideline for pharmacoeconomic research)College voor zorgverzekeringenAmstelveenGoogle Scholar
  4. 4.
    Nuijten, MJ, Brorens, MJ, Hekster, YA,  et al. 1998Reporting format for economic evaluation. Part I: Application to the Dutch healthcare systemPharmacoeconomics1415963PubMedGoogle Scholar
  5. 5.
    Nuijten, MJ, Pronk, MH, Brorens, MJ,  et al. 1998Reporting formats for economic evaluation. Part II Focus on modelling studiesPharmacoeconomics1425968PubMedGoogle Scholar
  6. 6.
    Postma, MJ, Kwik, JJ, Rutten, WJ, Jong-van den Berg, LTW, Brouwers, JRBJ 2002Overeenkomsten tussen richtlijnen voor farmaco-economisch onderzoek en eerder gepubliceerde gezonheideconomische evaluaties [Agreement between guidelines for pharmaco-economic research and never-before-published health-economics evaluations]Ned Tijdschr Geneeskd14610827PubMedGoogle Scholar
  7. 7.
    Postma, MJ, Kruidhof, J, Jong-van den Berg, LTW, Brouwers, JRBJ 2002Het groeiende belang van kosteneffectiviteitsanalyses. Theorie en praktijk van het farmaco-economisch onderzoek (The increasing importance of cost effectiveness analysis. Theory and practice of pharmacoeconomic research)Pharmaceutisch Weekblad13715826Google Scholar
  8. 8.
    Annemans, L, Bos, JM, Postma, MJ 2003Discounting health effects in pharmaco-economic evaluations; some additional elements to considerISPOR Connections935Google Scholar
  9. 9.
    Lazaro, A 2002Theoretical arguments for the discounting of health consequences. Where do we go from here?Pharmacoeconomics2094361PubMedGoogle Scholar
  10. 10.
    Welte, R, Konig, HH, Leidl, R 2000The costs of health damage and productivity losses attributable to cigarette smoking in GermanyEur J Public Health10318CrossRefGoogle Scholar
  11. 11.
    Meerding, WJ, Ballegooijen, M, Burger, MPM,  et al. 2002Human papillomavirus testing for triage of women referred because of abnormal smears: a decision analysis considering outcomes and costsJ Clin Epidemiol55102532CrossRefPubMedGoogle Scholar
  12. 12.
    Koopmanschap, MA, Rutten, FFH, Ineveld, BM,  et al. 1995The friction cost method for measuring indirect cost of diseaseJ Health Econ1417189CrossRefPubMedGoogle Scholar
  13. 13.
    Hout, BA, Simoons, ML 2001Cost effectiveness of HMG coenzyme reductase inhibitors; whom to treat?Eur Heart J2275161PubMedGoogle Scholar
  14. 14.
    Akazawa, M, Sindelar, JL, Paltiel, D 2003Economic costs of influenza-related work absenteismValue Health610715CrossRefPubMedGoogle Scholar
  15. 15.
    College voor zorgverzekeringen (Health Care Insurance Board)2001Farmacotherapeutisch Kompas 2002 (Pharmacotherapeutic Compass)College voor ZorgverzekeringenAmstelveenGoogle Scholar
  16. 16.
    Welte, R, Kretzschmar, M, Leidl, R,  et al. 2000Cost-effectiveness of screening programs for Chlamydia trachomatis: a population-based dynamic approachSex Transm Dis2751829PubMedGoogle Scholar
  17. 17.
    Oostenbrink, JB, Koopmanschap, MA, Rutten, FFH 2000Handleiding voor kostenonderzoek; methoden en richtlijnprijzen voor economische evaluaties in de gezondheidszorg [Guidelines for costing research methods and reference prices for economic evaluation in health care]College voor zorgverzekeringenAmstelveenGoogle Scholar
  18. 18.
    Os, N, Niessen, LW, Bilo, HJ,  et al. 2000Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelinesHealth Policy5113547PubMedGoogle Scholar
  19. 19.
    Stolk, EA, Busschbach, JJV, Caffa, M,  et al. 2000Cost utility analysis of sildenafil compared with papaverine-phentolamine injectionsBMJ3201165CrossRefPubMedGoogle Scholar
  20. 20.
    Joosen, EA, Reininga, JH, Manders, JM,  et al. 2000Costs and benefits of a test-and-treat strategy in Helicobacter pylori-infected subjects: a prospective intervention study in general practiceEur J Gastroenterol Hepatol1231925PubMedCrossRefGoogle Scholar
  21. 21.
    Postma, MJ, Heijnen, ML, Jager, JC 2001Cost-effectiveness analysis of pneumococcal vaccination for elderly individuals in the NetherlandsPharmacoeconomics1921522PubMedGoogle Scholar
  22. 22.
    Pinto, CG, Lafuma, A, Fagnani, F,  et al. 2001Cost-effectiveness of emedastine versus levocabastine in the treatment of allergic conjunctivitis in 7 European countriesPharmacoeconomics1925565PubMedGoogle Scholar
  23. 23.
    Bos, JM, Fennema, JS, Postma, MJ 2001Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in AmsterdamAIDS1520316CrossRefPubMedGoogle Scholar
  24. 24.
    Bos, JM, Rümke, HC, Welte, R,  et al. 2001Health economics of a hexavalent meningococcal outer-membrane vesicle vaccine in children: potential impact of introduction in the Dutch vaccination programVaccine202027PubMedGoogle Scholar
  25. 25.
    Nuijten, MJ, Iperen, P, Palmer, C,  et al. 2001Cost-effectiveness analysis of entacapone in Parkinson’s disease: a Markov process analysisValue Health431628PubMedGoogle Scholar
  26. 26.
    Jansen, R, Redekop, WK, Rutten, FF 2001Cost-effectiveness of continuous terbinafine compared with intermittent itraconazole in the treatment of dermatophyte toenail onychomycosis: an analysis of based on results from the L.I.ON study Lamisil versus Itraconazole in OnychomycosisPharmacoeconomics1940110PubMedGoogle Scholar
  27. 27.
    Doyle, JJ, Casciano, J, Arikian, S,  et al. 2001A multinational pharmacoeconomic evaluation of acute major depressive disorder (MDD): a comparison of cost-effectiveness between venlafaxine, SSRIs and TCAsValue Health41631CrossRefPubMedGoogle Scholar
  28. 28.
    Müller, E, Leen, MW, Bergemann, R 2001Economic evaluation of collagenase-containing ointment and hydrocolloid dressing in the treatment of pressure ulcersPharmacoeconomics19120916PubMedGoogle Scholar
  29. 29.
    Valkengoed, IGM, Postma, MJ, Morré, SA,  et al. 2001Cost-effectiveness analysis of a population based screening programme for asymptomatic Chlamydia trachomatis infections in women by means of home obtained urine specimensSex Transm Inf7727682Google Scholar
  30. 30.
    Krijnen, P, Kaandorp, CJE, Steyerberg, EW,  et al. 2001Antibiotic prophylaxis for haematogenous bacterial arthritis in-patients with joint disease: a cost effectiveness analysisAnn Rheum Dis6035966CrossRefPubMedGoogle Scholar
  31. 31.
    Boom, G, Rutten-van Mölken, MPMH, Molema, J,  et al. 2001The Cost-effectiveness of early treatment with Fluticasone propionate 250 μg twice a day in subjects with obstructive airway disease. Results of the DIMCA ProgramAm J Respir Crit Care Med164205766PubMedGoogle Scholar
  32. 32.
    Nuijten, MJ 2001Assessment of clinical guidelines for continuation treatment in major depressionValue Health428194PubMedGoogle Scholar
  33. 33.
    Postma, MJ, Welte, R, Hoek, JA,  et al. 2001Cost-effectiveness of partner pharmacotherapy in screening women for asymptomatic infection with Chlamydia TrachomatisValue Health426675CrossRefPubMedGoogle Scholar
  34. 34.
    Bock, GH, Erkel, AR, Springer, MP, Kievit, J 2001Antibiotic prescription for acute sinusitis in otherwise healthy adults. Clinical cure in relation to costsScand J Prim Health Care195863PubMedGoogle Scholar
  35. 35.
    Nuijten, MJ, Engelfriet, P, Duijn, K,  et al. 2001A cost–cost study comparing etanercept with infliximab in rheumatoid arthritisPharmacoeconomics19105164PubMedGoogle Scholar
  36. 36.
    Li, N, Agthoven, M, Willemse, P, Uyl-de Groot, C 2001A cost-utility analysis comparing second-line chemotherapy schemes in-patients with metastatic breast cancerAnticancer Drugs1253340CrossRefPubMedGoogle Scholar
  37. 37.
    Oostenbrink, JB, Tangelder, MJD, Busschbach, JJV,  et al. 2001Cost-effectiveness of oral anticoagulant versus aspirin in-patients after infrainguinal bypass grafting surgeryVasc Surg3425462Google Scholar
  38. 38.
    Lindgren, P, Jönsson, B, Redaelli, A, Radice, D 2002Cost-effectiveness analysis of exemestane compared with megestrol in advanced breast cancer: a model for Europe and AustraliaPharmacoeconomics201018PubMedGoogle Scholar
  39. 39.
    Hartman, M, Prins, M, Swinkels, OQ,  et al. 2002Cost-effectiveness analysis of a psoriasis care instruction programme with dithranol compared with UVB phototherapy and inpatient dithranol treatmentBr J Dermatol14753844CrossRefPubMedGoogle Scholar
  40. 40.
    Postma, MJ, Londeman, J, Veenstra, M,  et al. Feb 2002Cost-effectiveness of periconceptional supplementation of folic acidPharm World Sci24811CrossRefGoogle Scholar
  41. 41.
    Ten Berg, JM, Kelder, JC, Plokker, TH, Hout, BA 2002Costs and effectiveness of using coumarins before, during and after coronary angioplastyPharmacoeconomics2084753PubMedGoogle Scholar
  42. 42.
    Caro, JJ, Salas, M, Ward, A, Getsios, D, Mehnert, A 2002AHEAD Study Group. Assessment of Health Economics in Alzheimer’s Disease. Economic analysis of galantamine, a cholinesterase inhibitor, in the treatment of patients with mild to moderate Alzheimer’s disease in the NetherlandsDement Geriatr Cogn Disord14849CrossRefPubMedGoogle Scholar
  43. 43.
    Schermer, TR, Thoonen, BP, Boom, G,  et al. 2002Randomized Controlled Economic Evaluation of Asthma Self-Management in Primary Health CareAm J Respir Crit Care Med166106272CrossRefPubMedGoogle Scholar
  44. 44.
    Agthoven, M, Uyl-de Groot, CA, Fokkens, WJ,  et al. 2002Cost analysis of regular and filgrastim treatment in-patients with refractory chronic rhinosinusitisRhinology406974PubMedGoogle Scholar
  45. 45.
    Canadian Coordinating Office for Health Care Technology Assessment. Guideline for economic evaluation of pharmaceuticals: Canada. 1997. Ontario, CanadaGoogle Scholar
  46. 46.
    Edmunds, WJ, Medley, GF, Nokes, DJ 1999Evaluating the cost effectiveness of vaccination programmes: a dynamic perspectiveStat Med18326382CrossRefPubMedGoogle Scholar
  47. 47.
    Baladi, JF, Menon, D, Otten, N 1998Use of economic evaluation guidelines: 2 year’s experience in CanadaHealth Econ72217CrossRefPubMedGoogle Scholar
  48. 48.
    Australian Commonwealth Department of Health and Ageing2002Guidelines for the pharmaceutical industry on preparation of submissions to the pharmaceutical benefits advisory committeeCommonwealth Department of Health and AgeingCanberraGoogle Scholar
  49. 49.
    Ontario Ministry of Health and Long Term Care1994Ontario guidelines for economic analysis of pharmaceutical productsOntario-Ministry of Health and Long Term CareTorontoGoogle Scholar
  50. 50.
    Anis, AH, Gagnon, Y 2000Using economic evaluations to make formulary coverage decisions. So much for guidelinesPharmacoeconomics185562PubMedGoogle Scholar
  51. 51.
    Severens, JL 2001Economic evaluation in health care: the usefulness of research guidelinesEur J Obst Gyn Reprod Biol9457Google Scholar
  52. 52.
    Harrison DL. Evaluation and interpretation of pharmacoeconomic literature. Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Jarir Atthobari
    • 1
  • Jasper M. Bos
    • 1
  • Cornelis Boersma
    • 1
  • Jacobus R. B. J. Brouwers
    • 1
  • Lolkje T. W. de Jong-van den Berg
    • 1
  • Maarten J. Postma
    • 1
    Email author
  1. 1.Department of Social Pharmacy, Pharmacoepidemiology and PharmacotherapyGroningen University Institute for Drug Exploration (GUIDE)GroningenThe Netherlands

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