Big clinical trials may show that the new medications work, but not their cost-effectiveness. A recent MEDLINE study looks into this under-discussed subject.
The best-possible medications can’t offer you much if you can’t afford them. Even with health insurance, you may pay a significant amount each month in co-payments for medications alone.
The large randomized, controlled trial has become the accepted standard for assessing the value of a new treatment or medication. But more than half of these studies fail to assess in a meaningful way whether the new medication is actually worth the investment when compared with the old treatment, a new study reported in Value in Health (Volume 9, page 334 ) shows.
The researchers searched MEDLINE, a huge database of medical publications, for economic evaluations based on data collected from major randomized trials published in 2003. Of the 115 they found, only 37% included a cost-effectiveness ratio. Incomplete cost data were reported in 58% of studies, and only two of them reported how they analyzed cost data that had been censored in the original clinical study.
In 2003, the authors say, the quality of statistical evaluations conducted as part of randomized, controlled trials was poor. Unless this improves, they assert, people will not be able to make fully informed policy decisions about the value of new medications.
Bottom line: Meanwhile, if you have “sticker shock” about the cost of a new medication, ask your doctor whether the benefit is large enough to justify the expense. Your judgment about this and your doctor’s may be the best available for now.
