Value-based pharmaceutical care at population, hospital and patient level: Integrating value-based health care and cost-effectiveness analysis

At both the European and national levels, the introduction of numerous novel and innovative therapies is gaining momentum, often designed for and applied to large patient populations. From a population-level perspective, it is critical to ensure that these therapies are deployed efficiently, targeting the appropriate patient groups or subgroups. Efficiency in this context encompasses the avoidance of unnecessary treatments and the prevention of systematic overdosing, which could lead to suboptimal patient outcomes and increased healthcare costs. From a pharmaceutical point, it is imperative to systematically assess the long-term implications of these therapies for patient populations and their incorporation into clinical guidelines within hospital settings. The rapid evolution of hospital pharmacy practices, including advancements in pharmaceutical preparation, the expansion of specialized advisory roles, and the implementation of pricing models that align with real-world effectiveness, further underscores the need for a comprehensive evaluation. Moreover, it is essential to integrate the concept of value-based healthcare (VBHC), which prioritizes patient-centered care by focusing on patient-reported outcomes and linking these outcomes to the effectiveness of expensive drugs. The complementary nature of VBHC and cost-effectiveness analysis (CEA) offers the potential to develop new and more sustainable healthcare payment in the future perspective, where scarcity of resources and employees has an impact on the sustainability of pharmaceutical care in the Netherlands.

The main aim of this thesis is the integration of the concepts value-based healthcare (VBHC) and cost-effectiveness analysis (CEA) in pharmaceutical care on population, hospital and patient levels; mostly in the context of drugs often labeled as ‘expensive’.