Perspective (pharmacoeconomic)
Encyclopedia
Perspective in pharmacoeconomics
Pharmacoeconomics
Pharmacoeconomics refers to the scientific discipline that compares the value of one pharmaceutical drug or drug therapy to another. It is a sub-discipline of health economics. A pharmacoeconomic study evaluates the cost and effects of a pharmaceutical product...

 refers to the economic vantage point that is being taken in a pharmacoeconomic analysis, such as a cost-effectiveness analysis or cost-utility analysis
Cost-utility analysis
Cost–utility analysis is a form of financial analysis used to guide procurement decisions. The most common and well-known application of this analysis is in pharmacoeconomics, especially health technology assessment .-CUA in health economics:...

. This will affect the types of costs (resource expenditures) and benefits that will be considered relevant to the analysis.

Five general perspectives that are often cited in pharmacoeconomics include: institutional, third party, patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

, government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...

al and societal
Society
A society, or a human society, is a group of people related to each other through persistent relations, or a large social grouping sharing the same geographical or virtual territory, subject to the same political authority and dominant cultural expectations...

. The author must state the perspective and then insure that costs and valuations remain consistent with it throughout the study.

If, for example, a pharmacoeconomic study is done from the institutional perspective, the medication cost would be relevant to the resource expenditures involved in the delivery of the therapy. Since the institution (e.g. hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

) incurs this expense, then it would be included. Other relevant costs might include: inventory carrying cost, pharmacy time to compound or dispense, nursing time to administer, disposables (e.g. medication cups or intraveous tubing) and even allocated hospital overhead costs.

The next component of perspective that needs to be addressed under perspective is valuation. Valuation defines the currency reference that will be used to represent the resource expenditure associated with a given cost. When it comes time to determine the actual "dollar amount" to be attributed to the medication, it needs to be consistent with the perspective as well. Average wholesaler price (AWP) might NOT be considered an appropriate valuation of medication cost from an institutional perspective, if it does not represent the true cost to the institution. Average acquisition cost would be more relevant as a medication cost valuation.

More complex perspectives may require broader stables of resource expenditures (costs) and more intricate valuations. For example, in the "societal" perspective, it is necessary for the author to consider additional costs that would not be relevant to a given institutional perspective. One such example includes "lost productivity". Lost wages from work due to illness would not be relevant to an insitutional perspective, since these do not represent expenditures an average institution (e.g. hospital) will incur. From a societal perspective, they would need to be included. Lost productivity due to illness has an impact on society at large and must therefore be included and properly valued.
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