Pharmaco-economics: Making healthcare affordable

With the increased cost of medicines, patients have now grown wiser. Even those who can well-afford expensive drugs from multinational companies are asking their doctors for more reasonably priced products that are equally effective as the more expensive brands. This is the science of pharmaco-economics.

It is well-known that in developed and much more so in underdeveloped and developing countries, healthcare cost is a primary concern. Thus, it is increasingly important for medical practitioners, pharmacists and other healthcare givers to understand pharmaco-economics, which ensures administration of medicines, other healthcare products and services with the highest possible benefit to the patient in relation to the cash invested.

Pharmaco-economics compares the cost of the medicine, medical procedure or service to its anticipated benefits. Although cost containment is one of its goals, it is not necessarily synonymous with it since a low-cost medicine or service is not always synonymous with improved patient care. It is critical that healthcare products and services achieve the highest possible benefit from the cash invested.

The price of a medicine is not the true cost of that product. A cheap drug which is not effective and unable to treat the medical condition for which it was given, might lead to further complications, increased hospitalization expenses, diminished productivity and income.

On the other hand, what seems to be an expensive medicine, which is effective and leads to a quicker recovery from the illness, may turn out to be the true cheaper medicine once all the factors are considered.

What is ideal, of course, is an equally effective and reasonably priced or affordable medicine.

One of the objectives of pharmaco-economics is to improve patient compliance by providing effective and affordable medicines, which have to be taken religiously for several years, sometimes for life, as in life-long indications such as hypertension and diabetes.

Because of the perceived high cost of medicines, compliance has been poor and many patients opt not to take their prescribed medicines. They therefore take the "do nothing" alternative.

Many patients, however, do not realize that rarely does "doing nothing" cost nothing. In fact, it might cost the patient a lot, like when he develops a heart attack or stroke for not taking his medicines. In practically all medical conditions, there are always costs and consequences of doing nothing to treat the medical problem. It might even turn out more expensive in the long run.

It is the role of pharmaco-economics to inform clinicians and patients of all the costs and consequences of the use of competing alternative therapies. It will certainly be more cost-effective to prescribe the product with the lower price tag but with an equivalent or superior efficacy, coupled with improved compliance resulting in fewer repeat consultations and fewer repeat prescriptions, not to mention a better quality of life and productivity.

A good understanding of pharmaco-economics may serve to guide disease management and clinical decisions, and aid rational prescribing.

When one talks of pharmaco-economics, one has to talk about bioavailability and bioequivalence. Many people are confused when encountering either or both terms. They sound very similar but they are very different and cannot be used interchangeably.

The term "bioavailability" refers to the extent to which a drug or nutrient reaches its site of action or a biological fluid such as blood that has access to its site of action.

The term "bioequivalence" refers to pharmaceutically equivalent drug products, i.e., two brands with the same generic components, where the parameters for bioavailability of the active ingredients are not significantly different under suitable test conditions. In other words, this is a comparison of two or more products with respect to their bioavailability.

Bioequivalent simply means that one brand or dosage form of a drug or supplement is equivalent to a reference brand or dosage form of the same drug or supplement in terms of various bioavailability parameters measured via tests in human subjects.

There is no such thing as increased bioequivalence. A product can be either bio-equivalent or bio-inequivalent. A product cannot be more bio-equivalent or less bio-equivalent.

The various divisions of Unilab have made a firm commitment to provide the Filipino family with bioequivalent and reasonably priced medicines to achieve more optimum patient compliance.