FIVE MINUTES WITH Andrea J. Ries, PharmD by Alana Schwermer Andrea J. Ries, PharmD, a board certified pharmacotherapy specialist, has worked as a staff pharmacist at The Methodist Hospital in Houston and University Hospital in San Antonio. Currently she is a drug information specialist with the Department of Defense PharmacoEconomic Center at Fort Sam Houston in San Antonio. She also is a clinical assistant professor at the University of Texas at Austin College of Pharmacy. What is pharmacoeconomics? The literature says it is the description and analysis of the cost of drug therapy to health care and society. Everybody has their own take on this definition, but in general pharmacoeconomic research identifies, measures, and compares the cost for the resources consumed to the consequences. The consequences can be clinical, such as a decrease in blood pressure, or economic or humanistic, which focuses more on quality of life issues surrounding the patient. Pharmacoeconomics also looks at pharmaceutical products or services and then examines the outcomes or the impact of the drug therapy. Pharmacoeconomics is not new. The terminology may be new, but a lot of the concepts used in pharmacoeconomic methodologies have been around in the business arena for a long time, but just recently have become applied in the healthcare arena. Clinicians have always made pharmacoeconomic judgments. When people sit on a hospital pharmacy and therapeutics committee, they look at two drug therapies and make a decision on which to put on the formulary. Although it may not have been done formally in terms of evaluating the costs and all factors associated with one particular drug therapy as opposed to another, pharmacoeconomics is always inherent in evaluating drugs. But it’s becoming more formalized in terms of specific cost analysis and factoring in other things associated with drug therapy. Has increased focus by the healthcare industry on outcomes management and reducing healthcare costs increased the use of pharmacoeconomics? It has definitely increased the focus on the outcomes as well as the cost issue, and both of those in conjunction have moved pharmacoeconomics methodology and pharmacoeconomic research to the forefront. More and more institutions are trying to do some research in terms of looking at its use. Is pharmacoeconomics used only in pharmacy practice? Pharmacoeconomics is not only used in pharmacy practice. It is used in healthcare settings in general as well. It can be used in various ways and on various levels. In hospital formulary decisions, pharmacy and therapeutics committees decide what drugs are put on the formulary to treat patients. That’s something that lends itself to pharmacoeconomic analysis very nicely. In a more global healthcare setting or policy situation, pharmacoeconomics analysis can be used to determine what services are provided to beneficiaries or the healthcare plan. An example of this is determining whether to provide an immunization clinic or a hypertension clinic by considering the costs and benefits associated with each. Pharmacoeconomics can also be used to look at what is the best drug for a particular disease or a particular patient. There are various levels. There is a global policy level, an institutional level, and it can even be narrowed down to the patient level. You may not do a formal analysis at the individual patient level, but you’re still doing some sort of comparison of the costs and outcomes associated with a particular drug therapy.