Econ/Epi Exam 2

Question 1

what is the primary application of pharmecon to the real world

Answer 1

inform local decision making
formulary, guidelines, drug use policies, service eval, individual decisions

Question 2

3 pharmecon application strategies

Answer 2

use of published literature
build an economic model
conduct a PE study

Question 3

2 analysis types for pharmecon evaluations

Answer 3

prospective observational analysis
retrospective database analysis

Question 4

general steps of a pharmecon evaluation (5)

Answer 4

identify, measure, value resources/outcomes
select a study design
collect data
analyze data
interpret results

Question 5

5 main steps to design a pharmecon outcomes question

Answer 5

define problem
define objective
identify alternatives
formulate research hypothesis
establish framework

Question 6

general term for organizations which utilize a variety of techniques to provide healthcare in a cost-effective manner

Answer 6

managed care organization

Question 7

goals of MCOs

Answer 7

improve quality & accessibility of healthcare, healthcare outcomes, patient QoL, and contain costs

Question 8

7 things driving drug cost trends

Answer 8

aging population
better diagnoses
guideline changes
drug manufacturers
PBMs influencing drug costs
rare disease treatments
accelerated approvals

Question 9

strategy for cost-effective med use
continually updated list of meds which represent current clinical judgement of the P&T committee in diagnosis and preservation of health

Answer 9

formulary

Question 10

strategy for cost-effective med use
mandated/defined by gov’t agencies, meets quarterly, reviews coverage routinely to make sure classes are cost effective (creates formulary)

Answer 10

P&T committee

Question 11

strategy for cost-effective med use
2 components of appropriate use

Answer 11

utilization management
diagnosis editing

Question 12

3 methods for utilization management

Answer 12

prior authorization
step therapy
quantity limits

Question 13

strategy for cost-effective med use
2 types of DUR

Answer 13

concurrent or retrospective

Question 14

DUR type that reviews drug history at the time a claim is filled

Answer 14

concurrent DUR

Question 15

type of DUR that reviews past claim history

Answer 15

retrospective DUR

Question 16

strategy for cost-effective med use
medications that may be a medical vs rx benefit- may require additional care coordination

Answer 16

specialty meds

Question 17

strategy for cost-effective med use
2 provider initiatives

Answer 17

academic detailing
value based reimbursement

Question 18

the ability of a test to identify correctly those who HAVE THE DISEASE (true positive)

Answer 18

sensitivity

Question 19

ability of a test to identify correctly those who DO NOT HAVE THE DISEASE (true negative)

Answer 19

specificity

Question 20

measure of morbidity
number of new cases of a disease that occur during a specified period in a population at risk for developing the disease (excludes pre-existing cases)

Answer 20

incidence rate

Question 21

measure of morbidity
number of affected persons present in the population at a specific time divided by the # of persons in the population at that time

Answer 21

prevalence

Question 22

ratio of the risk of disease in exposed individuals to the risk of the disease in unexposed individuals

Answer 22

risk ratio

Question 23

when is risk ratio used

Answer 23

prospective, cohort studies

Question 24

ratio of the probability of occurrence of an event to that of non-occurrence

Answer 24

odds ration

Question 25

when is odds ratio used

Answer 25

retrospective, case-control studies

Question 26

rate at which an unfavorable event occurs, commonly used in survival analysis

Answer 26

hazard ratio

Question 27

amount or proportion of disease incidence or risk that can be attributed to a specific exposure

Answer 27

attributable risk

Question 28

measure of morbidity the number of people exposed to something and get the associated outcome divided by the total number of people exposed

Answer 28

attack rate

Question 29

number of deaths from a cause in a certain population over a specific period of time

Answer 29

mortality rate

Question 30

method used to adjust for differences in population characteristics when comparing disease or mortality rates between two or more groups

Answer 30

standardization

Question 31

standardization type estimates the rate of disease or death in the study population as if it had the same age distribution as a standard population

Answer 31

direct standardization

Question 32

standardization type compares the observed rate of disease or death in the study population to the expected rate based on a standard population

Answer 32

indirect standardization

Question 33

attributable risk of an entire population whether or not all in the population have direct exposure

Answer 33

population AR

Question 34

of patients who would have to receive the treatment for one of them to benefit

Answer 34

number needed to treat

Question 35

number of patients who receive a treatment before 1 adverse event occurs

Answer 35

number needed to harm

Question 36

a confidence interval reported ahead of the range indicates the probability that the range is

Answer 36

accurate

Question 37

wide confidence interval indicates

Answer 37

low precision, less credible values

Question 38

narrow confidence interval indicates

Answer 38

high precision, credible values

Question 39

for mean or risk differences, if a confidence interval includes 0, the result is

Answer 39

NOT STATISTICALLY SIGNIFICANT

Question 40

for odds/risk/hazard ratios, if the confidence interval includes 1, the result is

Answer 40

NOT STATISTICALLY SIGNIFICANT

Question 41

to interpret a confidence interval, you could say

Answer 41

it is likely that the true mean difference between two groups is somewhere between [1st number of range] and [2nd number of range]

Question 42

risk/odds/hazard ratio of 1 means

Answer 42

no association

Question 43

risk/odds/hazard ratio <1 means

Answer 43

negative association, protective

Question 44

risk/odds/hazard ratio of >1 means

Answer 44

positive association, risk-enhancing

Question 45

asheville project showed what main outcomes about claims

Answer 45

medical claims decrease prescription claims increase

Question 46

diabetes 10 city challenge primary claims outcomes

Answer 46

medical, rx, and total claims increased (but decreased vs projected costs) medical costs tend to rise

Question 47

what was found by the systematic review of pharmacy economic evaluations

Answer 47

service type dictates return on investment

Question 48

what was the MEDIAN BENEFIT:COST RATIO found by the systematic review of pharmacy economic evaluations

Answer 48

5:1

Question 49

based on summary by pharmacist service, which services are not consistently quantified for ROI

Answer 49

preventative care services, patient education or counseling

Question 50

based on summary by disease state, which have a positive ROI? which are limited?

Answer 50

positive- DM, HTN limited- dyslipidemia, astha/copd