Econ Exam 2

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Econ Exam 2
2010-10-14 08:38:52
Pharmacoeconomic Evaluation

Pharmacoeconomic Evaluation
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  1. Health Economics is best known for its
    techniques of economic evaluation
  2. Pharmacoeconomics began in
  3. The principle criterion used within economic evaluation is
  4. Identifies, measures and compares the costs and consequences of use of pharmaceutical products and services
  5. Inputs
    economic resources
  6. Outputs
    Health and economic consequences
  7. Pharmacoeconomics is about determinit alternatives that provide
    the best health care outcome per dollar spent
  8. Outcomes research is defined more broadly as
    studies that attempt to identify, measure and evaluate the results of health care services in general
  9. Pharmacoeconomics is not a synonym of
    outcomes research
  10. pharmacoeconomics is a division of
    • outcomes research
    • can be used to quantify the value of pharmaceutical products and services
  11. Distinquishes pharmacoeconomic evaluation methods from cost containment strategies
    cost and consequences
  12. the value of resources consumed by a program or drug therapy of intrest
  13. the effects, outputs or outcomes of the program of drug therapy of interest
  14. balancing costs and consequences with pharmacoeconomic evaluation
    cost per unit of effect
  15. resources consumed int he prevention, detection or treatment of disease or illness
    direct costs
  16. non-medical costs
    transportation, child/family care expenses
  17. Morbidity costs incurred from missing work or mortality costs from premature death
    Indirect costs
  18. Nonfinancial outcomes of disease
    intangible costs
  19. additional cost that a program or treatment alternative impose over another
    incremental costs
  20. value of a resource in its next best use
    opportunity costs
  21. human capital method & willingness to pay method
    Measure indirect and intangible benefits
  22. Human capital method
    • wage rate calculation
    • missed time because of illness
  23. Willingness to pay method
    open ended or close ended questions asked
  24. outcome unit is dollars
    cost-benefit analysis
  25. outcome unit is natural units (life-years gained, mmol/l blood glucose, mm Hg blood pressure)
  26. outcome unit is assumed to be equivalent in comparitive groups
  27. outcome unit is quality-adjusted life year or other utilities
  28. Evaluation method used if outcomes are measured but outcomes are not equivalent
    • CEA
    • CUA
    • CBA
  29. Economic evaluation used if outcomes are not being measured
  30. Full pharmacoeconomic evaluation
    • assesses both costs and benefits
    • CMA
    • CEA
    • CUA
    • CBA
  31. Partial pharmacoeconomic evaluation
    • examin only a portion of costs versus the consequences
    • cost analysis
    • cost of illness
  32. cost benefit analysis provides _________ efficiency information.
  33. cost utility analysis provide ________ efficiency information.
  34. Ecaluations provide information to
    assist in the decision making process
  35. more than one type of evaluation can be used simultaneously (T/F)
  36. Assessing the cost and consequences of products and service depends on the
    perspective of the evaluation
  37. common perspectives for evaluations are
    • patient
    • provider
    • payer
    • society
  38. measures cost incurred due to illness or treatment
    patient perspective
  39. measures primary costs of drugs, lab tests, supplies and salaries of health care professionals
    provider perspective
  40. measures costs from insurance companies, government or employer perspective
    payer perspecive
  41. considers benefit to society as a whole
    societal perspective
  42. determines how sensitive the results are to variation or uncertainty
    • sensitivity analysis
    • tornado diagram
  43. when to utilize CEA
    • treatment alternatives are not equivalent
    • not desireable to express outcomes in monetary units
  44. compares the cost and consequences of two or more therapies to determine which has the best outcome and lowest cost
  45. allows researchers to summarize the health benefits and resources used by policy competing programs so that policy makers can choose among them
  46. CEA are presented as an ______ ratio of costs to outcomes
  47. Incremental cost effectivness ratio calculation
    (cost 1 - cost 2) / (outcome 1 -outcome 2)
  48. Reflects the cost per benefit of a new strategy independent of other alternatives
  49. reflects cost per unit of benefit of switching treatmets
  50. a form of pharmacoeconomic evaluation that integrates both costs and consequences of health programs within the utility analysis framework
  51. CUA is often considered as an extension of
  52. CUA can compare ____, ____ and _____ for patient years
    • cost
    • quality
    • quantity
  53. results of CUA are most often expressed as
    cost per QALY gained
  54. a full year of health in a disease fre patient would equal
    1 qualy
  55. Scales for measuring QALY
    • visual analogue scale
    • Standard Gamble
    • Time Trade off
  56. single index incorporating mortality and morbidity in health care
  57. VAS scale
    rating from 0 (least) to 100 (most) desirable health state
  58. VAS
    • most commonly used technique
    • not a true measure of utility
    • measures preferences under certainty (value)
  59. Standard Gamble
    • involves uncertainty
    • willingness to accept risks
    • gold standard
  60. Time Trade off
    quality of life vs quantity of life
  61. differences between CEA and CUA
    • CUA is a special case of CEA
    • patient preference in the denominator of the ratio
    • CUA:QALY
    • CEA:Natural units
    • intermediate outcomes not used in CUA
  62. the most difficult and expensive method when compared to other types of evaluations
  63. CUA is recommended when:
    quality of life is the important outcome
  64. CUA should be employed when
    • the program affects both morbidity and mortality
    • there is a common unit of outcome
    • wide range of outcomes
  65. Categories of benefits for CBA
    • personal health benefits
    • medical resource benefits
  66. Advantages of CBA
    • compare alternatives that do not have the same unit of effectivness
    • determine program with highest net benefit
    • ranks programs by priority
    • stimulates research for alternatives
    • points out inferior programs
  67. Disadvantages of CBA
    • only when outcomes can be converted to dollars
    • bias may occur in value of outcomes
    • intangible costs are not measured
    • must use sensitivity analysis
  68. projects with highest benefit:cost ratio should be used when
    resources are limited
  69. use projects with B:C ratio greater than one when
    funds allow
  70. first 5 guidlines for conducting pharmacoeconomic analysis
    • 1. define problem
    • 2. determine perspective
    • 3. determine alternatives
    • 4. select the method
    • 5. select and measure costs and outcomes
  71. last 5 guidlines for conducting pharmacoeconomic analysis
    • 6. identify resources
    • 7. establish probabilities of outcome events
    • 8. use decision analysis
    • 9. discount costs and sensitivity analysis
    • 10. present results