VANCOUVER, BC-The use of pharmacoeconomics in cancer pain management
is not about "decreasing the drug budget," but rather
about evaluating the cost and outcomes of drug therapy, Stephen
L. Huber, MS, RPh, said at a symposium held in conjunction with
the 8th World Congress on Pain.
The most important part of the formula may be outcomes, said Mr.
Huber, director of pharmacoeco-nomics, The University of Texas
M.D. Anderson Cancer Center. "We have shifted our focus to
look at drug performance rather than just drug cost," he
said, "so that an increased drug cost may be acceptable if
the outcome is enhanced."
Without outcomes data, "we're really kind of shooting in
the dark," he said. "You have to have outcomes data
to find out if your cancer pain guidelines work in a particular
patient. Then you can feed that data back into the process."
He also stressed that outcome goals must include quality of life,
rather than just reaching a certain numerical level of pain control.
"A difference is not a difference unless it makes a difference
. . . to the patient," said Mr. Huber, paraphrasing a Gertrude
As an example, he described a patient on the Pain and Symptom
Management Service at M.D. Anderson whose pain was reduced with
treatment from a level of 8 to 2 (on a 10-point scale in which
5 is generally considered significant pain), and yet the patient
wasn't satisfied with his pain management because he was too sedated
to play the piano.
"He was willing to accept a higher level of pain to get the
goal he wanted in terms of functionality," Mr. Huber commented.