{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T22:41:23Z","timestamp":1769121683618,"version":"3.49.0"},"reference-count":24,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evid Based Med"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>The need for comparative effectiveness (CE) data continues to grow, fuelled by market demand as well as health reform. There may be an assumption that new drugs result in improved efficacy compared with the standard of care, therefore warranting premium prices. Gout treatment has recently become controversial, as expensive new drugs enter the market with limited CE data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors reviewed published clinical trials and conducted a cost effectiveness analysis on a new drug (febuxostat) versus the standard (allopurinol) to illustrate the limitations in using these data to inform evidence-based decision-making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Although febuxostat trials included allopurinol as a comparator, methodological limitations make comparative effectiveness evaluations difficult. However, when available trial data were input to a decision analytic model, the authors found that a significant reduction in febuxostat cost would be required in order for it to dominate allopurinol in cost effectiveness analysis. This case exemplifies the challenges of using clinical trial data in comparative and cost effectiveness analyses.<\/jats:p><\/jats:sec>","DOI":"10.1136\/ebmed-2011-100065","type":"journal-article","created":{"date-parts":[[2012,2,19]],"date-time":"2012-02-19T01:34:19Z","timestamp":1329615259000},"page":"105-108","source":"Crossref","is-referenced-by-count":9,"title":["Payer decision-making with limited comparative and cost effectiveness data: the case of new pharmacological treatments for gout"],"prefix":"10.1136","volume":"17","author":[{"given":"Michele","family":"Meltzer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura T","family":"Pizzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Jutkowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,2,18]]},"reference":[{"key":"2024052112491752000_17.4.105.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-3-200908040-00126"},{"key":"2024052112491752000_17.4.105.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0902427"},{"key":"2024052112491752000_17.4.105.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1409"},{"key":"2024052112491752000_17.4.105.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2009.00560.x"},{"key":"2024052112491752000_17.4.105.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb0911104"},{"key":"2024052112491752000_17.4.105.6","first-page":"562","article-title":"Medication errors with the use of allopurinol and colchicine: a retrospective study of a national, anonymous Internet-accessible error reporting system","volume":"33","author":"Mikuls","year":"2006","journal-title":"J Rheumatol"},{"key":"2024052112491752000_17.4.105.7","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903017966"},{"key":"2024052112491752000_17.4.105.8","doi-asserted-by":"crossref","first-page":"229","DOI":"10.7326\/0003-4819-64-2-229","article-title":"Allopurinol in the treatment of gout","volume":"64","author":"Rundles","year":"1966","journal-title":"Ann Intern Med"},{"key":"2024052112491752000_17.4.105.9","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.10.981"},{"key":"2024052112491752000_17.4.105.10","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(84)90743-5"},{"key":"2024052112491752000_17.4.105.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe058247"},{"key":"2024052112491752000_17.4.105.12","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328325bd94"},{"key":"2024052112491752000_17.4.105.13","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep087"},{"key":"2024052112491752000_17.4.105.14","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2009.236"},{"key":"2024052112491752000_17.4.105.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0912651"},{"key":"2024052112491752000_17.4.105.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050373"},{"key":"2024052112491752000_17.4.105.17","doi-asserted-by":"publisher","DOI":"10.1002\/art.24209"},{"key":"2024052112491752000_17.4.105.18","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken457"},{"key":"2024052112491752000_17.4.105.19","doi-asserted-by":"publisher","DOI":"10.1186\/ar2978"},{"key":"2024052112491752000_17.4.105.20","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.055251"},{"key":"2024052112491752000_17.4.105.21","unstructured":"National Institute for Health and Clinical Excellence (NICE). NICE technology appraisal guidance 164: febuxostat for the management of hyperuricaemia in people with gout. 2008. http:\/\/www.nice.org.uk\/nicemedia\/pdf\/TA164Guidance.pdf (accessed 11 November 2011)."},{"key":"2024052112491752000_17.4.105.22","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1457-8"},{"key":"2024052112491752000_17.4.105.23","doi-asserted-by":"publisher","DOI":"10.1002\/art.20935"},{"key":"2024052112491752000_17.4.105.24","unstructured":"Drugstore.com Online Pharmacy. Drug prices for febuxostat and allopurinol. http:\/\/www.drugstore.com\/.(accessed 11 October 2009)."}],"container-title":["Evidence Based Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ebmed-2011-100065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T19:49:27Z","timestamp":1716320967000},"score":1,"resource":{"primary":{"URL":"https:\/\/ebm.bmj.com\/lookup\/doi\/10.1136\/ebmed-2011-100065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,18]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2012,7,28]]},"published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1136\/ebmed-2011-100065"],"URL":"https:\/\/doi.org\/10.1136\/ebmed-2011-100065","relation":{},"ISSN":["1356-5524","1473-6810"],"issn-type":[{"value":"1356-5524","type":"print"},{"value":"1473-6810","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,18]]}}}