Pharmaeconomics in Developing Countrie

We have wrote to the editor and published in Pharmacoeconomic journal (Shafie AA, Hassali MA. Pharmacoeconomics. 2011;29(1):83-5.), in response to Babar & Scahill 2010 (Babar ZUD, Scahill S. PharmacoEconomics. 2010;Published ahead of print.). Babar & Scahill have argued against using pharmacoeconomic in developing countries because of the supposedly weak health system in the countries and complexities of the tool. They have promoted the use of drug pricing policy instead.

In our letter we argued about the vague intention of their model, and bias of the model factor selection. We stressed that pharmacoeconomic never set itself as first line or any line sequence. In fact this thinking is dangerous as pharmacoeconomic is not a treatment against a clinical disease when a subsequent agent is prescribed once the first line failed. Pharmacoeconomic should be viewed as a tool that complement other strategies in making efficient use of resources or choice. As such, they should be equally promoted rather than demoted in its application. What’s more in a strained resource developing country.

Their response to our letter is more bewildering. They argue about economic analysis in the beginning but conclude with pharmacoeconomic modelling. Nowhere in our letter we mentioned about ‘three-model approach’ and the specific model that we quoted is just an example of other models that existed. Nowhere in our letter we said that formulary management is not a component of health policy. We are referring to component they proposed in the model rather than the relationship between formulary management and health policy. Finally their counter argument that their sources were published in ‘top-tiered journal’ does not hold water as it is a well established fact ‘top-tiered’ journal does not prove credibility and free of bias.