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The conceptual framework of value used by manufacturers is dominated by comparative clinical effectiveness, additional benefits, and the intrinsic value of having multiple treatment options, whereas the conceptual framework of value used by payers in the United States is dominated by comparative clinical effectiveness and budget impact, he said doxycycline for dogs side effects I know it s clichГ© to say that nothing else matters if you don t have your health, but that doesn t make it any less true