Pharmaceutical Executive Europe IMS Health Economics Supplement - December 2007 - (Page 7)

Redressing the Balance Xavier Badía considers an appropriate balance of evidence-based medicine and health outcomes research. E vidence-based medicine (EBM) is the most appropriate way to apply best evidence from research to daily clinical practice. In many cases, however, it is not representative of real-world patient presentations, nor does it adequately reflect their views and preferences. Health outcomes research (HOR) stresses the importance of real results from daily clinical practice and prioritises economic and patient variables, which potentially have been undervalued. These approaches do not have to be mutually exclusive and can, in fact, be complementary. their patients prefer. Importantly, it has been shown that identifying and incorporating patient preferences into a shared process of decision-making achieves better results for patients — including better quality of life, satisfaction with treatment, therapeutic bond and lifestyle modification. Real outcomes HOR is an attempt to highlight the importance of real outcomes encountered in clinical practice and to prioritise the economic and outcome variables centred on the patient. The results of HOR studies allow a better understanding of illnesses and their clinical treatment, and should form part of the evaluation process for determining the effectiveness of health services. Patient values Beyond searching for results in the available medical literature, EBM implies an ongoing process of examination and analysis of scientific works to find methodologically sound studies that are useful and adequate. Perhaps at its inception this movement was not sufficiently clear in underlining the importance of assessing the patient and his or her personal and social circumstances and preferences, and combining this evidence with the doctor’s professional experience. Patient values and preferences, clearly a key part of decision-making, often become a declaration of intent or an after-thought to a study or report. In spite of the fact that little account is taken of patients’ views in clinical practice, more and more information is now coming to light on the discrepancies between what doctors think and what Missing link Failure to systematically assess the effectiveness of treatments and health measures has significant repercussions. The gap between the results suggested by evidence-based studies (including randomised clinical trials [RCTs], meta-analyses and clinical practice guidelines [CPGs]) and the reality of doctors’ surgeries remains unchanged with the passage of time. Studies in countries including the US and the Netherlands suggest that at least 30–40% of patients do not receive medical care that is in keeping with the available scientific evidence, whilst 20% or more of treatments are either unnecessary or potentially harmful to patients. European studies on the secondary 7

Table of Contents for the Digital Edition of Pharmaceutical Executive Europe IMS Health Economics Supplement - December 2007

Pharmaceutical Executive Europe IMS Health Economics Supplement - December 2007
Budget Impact Analyses: BIAs: The Fifth Hurdle?
Evidence and Effectiveness: Redressing the Balance
Commercializing HEOR: Adding Value

Pharmaceutical Executive Europe IMS Health Economics Supplement - December 2007