Cost-Effectiveness Analysis Abroad
This chapter focuses on how international experience in using cost-effectiveness information explicitly to inform formulary decisions provides a remarkable contrast to that of the U.S. For a number of years, the U.K., Canada, Australia, and other countries have incorporated cost-effectiveness considerations explicitly into processes for making coverage and pricing decisions about drugs and other technologies. Unlike the U.S., where there has been little public acknowledgment of limits to health resources, a number of European countries—including Norway, Denmark, Sweden, and the Netherlands—established national commissions in the 1980s and 1990s to discuss priorities and choices, and to create an explicit framework for limit setting. While these commissions elicited controversy, they were also greeted by public discussions and broad-based support of the need for a limit-setting process.
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