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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adalimumab, Anti-Inflammatory Agents, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Benzamides, Decision Making, Drug Costs, Economics, Pharmaceutical, Evidence-Based Practice, Filgrastim, Granulocyte Colony-Stimulating Factor, Health Expenditures, Humans, Imatinib Mesylate, Insurance, Health, Reimbursement, Netherlands, Piperazines, Polyethylene Glycols, Pyrimidines, Recombinant Proteins, Reimbursement Mechanisms, Uncertainty.
user
Do reassessments reduce the uncertainty of decision making? Context: To investigate the desirability and feasibility of a cyclic reimbursement process to address uncertainty accompanying initial decision making. We performed desk research for three expensive outpatient drugs: imatinib, pegfilgrastim, and adalimumab. We analysed the evidence base at the time of decision making (T=0) and May 2011 (T=1). For T=0, public reports of the Dutch reimbursement agency were investigated regarding available clinical and economic evidence, and a systematic review was performed to retrieve additional economic evidence. For T=1, the systematic review was extended till May 2011. The evidence base at T=0 lacked information on clinically relevant outcomes such as mortality, morbidity, and quality of life (5/8 reports), (long-term) adverse events (2/8 reports) and experience in use (1/8 reports). One budget impact analysis and one economic evaluation were available but no pharmacoeconomic dossiers. The systematic review identified 39 cost-utility studies (of 52 economic evaluations) for T=1, characterised by methodological heterogeneity.
assistant
Given the considerable uncertainty accompanying initial decision-making, a more cyclic reimbursement process seems feasible to reduce uncertainty regarding the therapeutical and economical value of expensive drugs. A mandatory evidence development requirement seems desirable to sufficiently meet decision makers' needs.