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Direct Medical Costing for Economic Evaluations: Methodologies and Impact on Study Validity

Costing is central to any pharmacoeconomic evaluation. Recent guidelines on the conduct of pharmacoeconomic studies have outlined a framework for costs that should be included in any economic evaluation. Little research has been done, however, to compare the different methods of data collection used to derive estimates of direct medical costs. This paper addresses the different techniques used to cost medical care resources and the sources of data: direct from case report forms (CRFs), codable CRFs, bill extraction, cost prediction models, databases, and panel data. It offers insight as to the relative merits and drawbacks of the different procedures and offers guidance as to when it is most appropriate to use the different techniques. The paper concludes with a discussion on how the external and internal validity of studies are impacted by the use of the different costing methodologies.