Where market values were absent (e.g. volunteer labour), or market values did not reflect actual values (such as clinic space donated at a reduced rate), were adjustments made to approximate market values?
Pharmacoeconomics
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Get Help Now!Critique the two papers (Wonderling et al., 2004, Zhang and Hay, 2005) see documents( i sent) using the Drummond checklist.
Based only on the evidence presented in these two papers how would you allocate resources set aside to deal with migraine (acupuncture vs. triptans). What is the basis for your decision?
Be sure to answer both questions fully. So, for example, if the answer to an item on the Drummond check list is “Yes”, you need to give the reasons why you have answered “Yes” otherwise you will get no marks.
References
WONDERLING, D., VICKERS, A. J., GRIEVE, R. & MCCARNEY, R. 2004. Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care. BMJ, 328, 747-.
ZHANG, L. & HAY, J. W. 2005. Cost-effectiveness analysis of rizatriptan and sumatriptan versus Cafergot in the acute treatment of migraine. CNS Drugs, 19, 635-42.
Atholl Johnston, Tuesday, November 5th, 2013
Drummond’s check-list for assessing economic evaluations
(Drummond M et al. Methods for the economic evaluation of health care programmes. 2nd Edition, Oxford. Oxford University Press, 1997)
1. Was a well-defined question posed in answerable form?
1.1. Did the study examine both costs and effects of the service(s) or programme(s)?
1.2. Did the study involve a comparison of alternatives?
1.3. Was a viewpoint for the analysis stated and was the study placed in any particular decision-making context?
2. Was a comprehensive description of the competing alternatives given (i.e. can you tell who did what to whom, where, and how often)?
2.1. Were there any important alternatives omitted?
2.2. Was (should) a do-nothing alternative be considered?
3. Was the effectiveness of the programme or services established?
3.1. Was this done through a randomised, controlled clinical trial? If so, did the trial protocol reflect what would happen in regular practice?
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3.2. Was effectiveness established through an overview of clinical studies?
3.3. Were observational data or assumptions used to establish effectiveness? If so, what are the potential biases in results?
4. Were all the important and relevant costs and consequences for each alternative identified?
4.1. Was the range wide enough for the research question at hand?
4.2. Did it cover all relevant viewpoints? (Possible viewpoints include the community or social viewpoint, and those of patients and third-party payers. Other viewpoints may also be relevant depending upon the particular analysis.)
4.3. Were the capital costs, as well as operating costs, included?
5. Were costs and consequences measured accurately in appropriate physical units (e.g. hours of nursing time, number of physician visits, lost work-days, gained life years)?
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