The cost-effectiveness of drug regulation: the example of thorough QT/QTc studies.

J.C. Bouvy, M.A. Koopmanschap, R.R. Shah, H. Schellekens

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

We analyzed the cost-effectiveness of the International Conference on Harmonisation (ICH) E14 guideline that requires a thorough QT/QTc (TQT) study for all drugs under development. We compared two pharmacoeconomic scenarios: the health effects and costs resulting from implementing ICH E14 ("regulation" scenario) vs. not implementing ICH E14 ("no regulation" scenario). We used a dynamic population model to calculate the cost-effectiveness of ICH E14 for a prototype QT-prolonging antipsychotic drug entering the US and European markets. The incremental cost-effectiveness ratios of regulation vs. no regulation were ~euro2.4 million per sudden cardiac death prevented and ~euro187,000 per quality-adjusted life year (QALY) gained in users of antipsychotic drugs. The main driver of cost was the requirement for electrocardiogram (ECG) monitoring of users of QTc-prolonging drugs. Even when several of the assumptions in the model were varied, there were no results in favor of regulation. Our study shows that cost-effectiveness analysis of drug regulatory measures is feasible and should be considered before developing such measures.
Original languageUndefined/Unknown
Pages (from-to)281-8
Number of pages8
JournalClinical Pharmacology and Therapeutics
Volume91
Issue number2
Publication statusPublished - 2012

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