Application of an Economic Evaluation Approach to Making Regulatory Decisions Regarding Access to Medicines: Advantages, Challenges and Recommendations

Bonny Parkinson*, Henry Cutler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Initially patients require a prescription to access most new medicines. Some medicines may later be reclassified allowing patients to access them without a prescription. Currently the Australian Therapeutic Goods Administration (TGA) guidelines regarding reclassification decisions focus on patient risk, rather than potential benefits to patient health and the healthcare system.

We conducted two extensive case studies demonstrating an economic evaluation approach to medicine reclassification in Australia, which were presented at various conferences and to key stakeholders. This article discusses the advantages and challenges of using an economic evaluation approach to inform medicine reclassification decisions.

Advantages identified include: systematically and transparently synthesising evidence from multiple sources; predicting the overall expected impact of reclassification on health outcomes and costs before it occurs; considering a broader range of risks and benefits; aggregation of health impacts into a single measure (quality adjusted life years); identification of drivers of uncertainty; insight into the impact of different regulatory decisions; and improved consistency of evidence. Challenges include: data availability and quality; estimating behavioural changes; model complexity; lack of an incremental cost-effectiveness ratio threshold; and funding of economic analyses.

We recommend that regulatory decision makers use an economic evaluation approach to help inform reclassification decisions. Although, economic evaluation results should be considered as part of the broader body of evidence. Ultimately the use of an economic evaluation approach will contribute to helping decision makers maximise population health outcomes in an efficient way.
Original languageEnglish
JournalAustralian Health Review
Publication statusAccepted/In press - 16 Apr 2021


  • cost-effectiveness
  • over-the-counter
  • economics
  • behind-the-counter
  • nonprescription drugs
  • prescription drugs


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