Schwerpunkt| Volume 108, ISSUE 7, P360-366, 2014

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Revolution then evolution: The advance of health economic evaluation in Australia

  • Author Footnotes
    1 LWC Health Pty Ltd, 10 Hopegood Place, Garran ACT 2605, Australia
    Ruth Lopert
    Corresponding author: Dr Ruth Lopert, Director, LWC Health Pty Ltd and Adjunct Professor, Department of Health Policy, George Washington University, Washington DC.
    1 LWC Health Pty Ltd, 10 Hopegood Place, Garran ACT 2605, Australia
    LWC Health Pty Ltd, Canberra, Australia

    Department of Health Policy, George Washington University, Washington DC
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  • Rosalie Viney
    Centre for Health Economics Research and Evaluation, University of Technology, Sydney and Chair, Economics Subcommittee, Pharmaceutical Benefits Advisory Committee
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  • Author Footnotes
    1 LWC Health Pty Ltd, 10 Hopegood Place, Garran ACT 2605, Australia


      All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health.


      Weltweit sehen sich Regierungen damit konfrontiert, ihren Bürgern eine bezahlbare Gesundheitsversorgung sichern zu müssen. Einen Schlüsselfaktor für die Ausgabensteigerung stellen insbesondere neuartige Therapien dar. Auch wenn es zwischen den Ländern Unterschiede in den Methoden und Prozessen gibt, wie man zu Erstattungsentscheidungen kommt, so wird doch die Kosten-Nutzen-Bewertung mehr und mehr als wichtiges Instrument bei der Entscheidungsfindung um neue Therapieformen angesehen. Als Kriterium, ob ein neues Arzneimittel in das Pharmaceutical Benefits Scheme, die Liste der zu erstattenden Arzneimittel, aufgenommen werden soll, wurde die Kosten-Nutzen-Bewertung gegen Ende der 1980er-Jahre in Australien eingeführt. 1993 wurde sie verpflichtend. Damit ist Australien das erste Land, das eine solche Anforderung auf nationaler Ebene eingeführt hat. Seitdem wurde die Nutzung von Kosten-Nutzen-Bewertungen auch auf Entscheidungen zu nichtmedikamentösen Gesundheitstechnologien und auch auf Public-Health-Interventionen ausgeweitet.



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