Coverage with Evidence Development: Application to pharmaceutical reimbursement decisions

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Some new medicines produce only a small improvement in health but have considerable costs. When these medicines are trialled on only small numbers of people, uncertainty results about the value of the medicine, which can create problems for decision makers. Funding medicines where there is uncertainty may lead to harm when medicines are later found to be unsafe, or waste millions of dollars when they are overpriced relative to effectiveness. Not funding medicines may disadvantage patients in whom the medicines are effective. Methods to enable access to medicines while reducing uncertainty will offer significant benefit to patients, clinicians and taxpayers.