Hannah Jackson

RESEARCH THESIS

The pharmacoeconomics of medication use in pregnancy: An exploration of costs and equity.

Background  

Medication use during pregnancy is common, with evidence suggesting >80% of women take at least one medication during pregnancy. Moreover, women are entering pregnancy with higher rates of obesity and advanced maternal age, which contribute to the rising incidence of maternal chronic disease and pregnancy-related complications. Some of these medical conditions (e.g., diabetes, iron deficiency anaemia, pre-eclampsia) may require episodic or ongoing management with pharmaceutical agents. Despite a growing demand for medication use during pregnancy, pregnant women are commonly excluded from clinical studies, leaving them and their healthcare professionals with insufficient data to guide the safe, effective, and efficient use of medications during pregnancy. Overcoming the regulatory and legislative barriers to address this information gap is a complex challenge.

Objective

This body of research aims to analyse and describe the cost and equity implications associated with women’s access to medication during pregnancy.

Methods

The theoretical and conceptual framework is of this research is underpinned by economic evaluation and the provision of value-based health care. Initially, a review of the structural determinants of health inequities that impact access to medications during pregnancy will be undertaken to illuminate the highly upstream factors that act as barriers to medication access. Subsequently, a series of studies will explore the real-world costs and equity implications associated with women’s access to medications during pregnancy utilising a population-level linked administrative dataset, Maternity1000, which contains information on 250,000 women who gave birth in Queensland, Australia, between 1 January 2013 and 30th June 2018.

Expected Outcomes/ Impact

It is anticipated that gaining deeper insights into the structural factors influencing resource allocation decisions in maternal health care and describing the real-world economic and equity implications of these decisions will stimulate system-level changes that enable more efficient and equitable allocation of publicly funded resources for pregnant populations, ultimately enhancing maternal health outcomes.