Abstract
Since 1990, Australia has required that comparative cost-effectiveness be considered in the evaluation of pharmaceuticals when deciding whether a drug should be subsidized on the national formulary. This paper covers Australia's experience with this requirement to date. An outline of the Australian health care system within which the guideline operates is provided. A proposed revision emphasizes clinical comparison, with a preference for measurement over opinion and a more thoughtful approach to the need to address both internal validity of an economic evaluation and its relevance to a decision maker.
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