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Econ Exam 1 Flashcards

1
Q

Cost-Minimization Analysis (CMA)

A

compares cost of treatments with equivalent outcomes

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2
Q

Cost-Effectiveness Analysis (CEA)

A

measures costs in dollars and outcomes in natural health units —it is the most common type

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3
Q

Cost-Utility Analysis (CUA)

A

measures costs in dollars and outcomes in quality adjusted life year (QALY)
takes patient preference/satisfactions (utilities) into account
a subset of CEA-outcomes in natural health units

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4
Q

Cost-Benefit Analysis (CBA)

A

compares both costs and benefits in monetary units $
used in wildlife, irrigation and flood control, air quailty

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5
Q

Economics

A

The study of how individuals and societies choose to allocate scarce resources, why they choose to allocate them that way, and the consequences of those decisions.

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6
Q

Microeconomics

A

The study of individual decisions
Suppy,demand, elasticity

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7
Q

Macroeconomics

A

The study of the economy as a whole
-inflation, unemployment -the country

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8
Q

Utility (Satisfaction)

A

Satisfaction obtained from purchasing a particular good or service
if utility of a good is greater than its cost=BUY

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9
Q

Patient Perspective

A

Pays for the costs not covered by insurance companies
-copayments, deductibles and any out of pocket costs

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10
Q

Provider Perspective

A

Pays for the costs of providing products or services
-drugs, hospitalization and lab test

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11
Q

Price

A

the charge

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12
Q

Cost

A

the input

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13
Q

ECHO

A

Economic, Clinical, Humanistic, Outcome

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14
Q

Traditional Cost Category

A
  1. Direct Medical Costs
  2. Direct Non-medical costs
  3. Indirect costs
  4. Intangible costs
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15
Q

Direct Medical Costs

A

most obvious cost to measure
directly related to medical treatment
-diagnostic tests, hospitalization, home infusion, medical visits
ambulance to ER service
buying an OTC cold medicine from a local pharmacy

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16
Q

Direct Non-medical Costs

A

Cost to the patient that are directly associated with treatment but are not medical in nature
Examples: cost of traveling to and from clinic, food and lodging for out of town treatment, child care services
-gas fee spent on the way to clinic where you receive steroid injections
-you order food while waiting for son to finish chemo
-buying plane ticket to care for moms recovery
-uber fee spent

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17
Q

Indirect Costs

A

Result from the loss of productivity due to death/illness
Examples: Missing work, or reduced productivity at work due to treatment
-taking a week off from your work to care for ill mom
-come back to work after knee surgery and are slower

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18
Q

Intangible Costs

A

costs of non-financial outcomes of disease and medial care
examples: nausea from chemotherapy, anxiety during mri scan so take xanax

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19
Q

Consumer price index (CPI)

A

measure of the average change over time in the prices paid by the consumers

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20
Q

standardization of costs

A

bringing past costs to the present
CPI as indicator
MULTIPLY (must always add 1 before)
if CPI=4.4%
change to decimal –> 0.044
then add 1 (1+0.044)=1.044
now can multiply the cost by that

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21
Q

discounting of costs

A

brining future costs to the present
DIVIDE (must always add 1 before)
if Discount rate= 5%
change to decimal –> 0.05
then add 1 (1+0.05)=1.05
now can divide the cost by that

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22
Q

Average Wholesale price (AWP)

A

list price/sticker price
higher than what pharmacies actually pay for the meds
-redbook-micromedex

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23
Q

wholesale acquisition cost (WAC)

A

catalog price
sale deals and discounts/rebates NOT included

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24
Q

average manufacturer price (AMP)

A

amount paid by wholesaler after all sales deals are included
more precise
not available to public

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25
Common sources for US reimbursement rates
physician fee reference medicare reimbursement rates from CMS (Centers for Medicare and Medicaid Services)
26
Personnel Costs
consideration of the amount of time spent by medical personnel (work time)
27
Hospitalizations
1. per diem 2. disease-specific per diem 3. diagnosis related group 4. micro-costing (more precise as you read down)
28
per diem
average cost per day for all types of hospitalizations (key words: per day, all)
29
disease-specific per diem
estimate the costs based on specific disease state -appendectomy, cardiac bypass surgery costs, small joint repairs and cataract surgery costs etc.
30
diagnosis related group
classify diagnosis/procedures that use similar resources control medicare costs each category has its own reimbursement rate based on: diagnosis, secondary diagnosis, age, sex, and discharge status each-patient is categorized
31
micro-casting
collects information on resource use for each component of hospitalization -need to review patients hospital record
32
Complete title
Good Example  Cost Benefit Analysis of Ibuprofen vs. Tylenol in Pediatric Patients with Common Cold Symptoms  Bad Examples  (Pharmacoeconomic Analysis) of Glipizide vs. Glyburide in the Veterans Administration  Cost-Effectiveness Analysis of (Two Antibiotic) Therapies in a Large Teaching Hospital  (Ultraceph Found Cost-Effective) When Compared to Megaceph
33
Clear objective
stated in the beginning-usually in objective section -to calculate the benefit to cost ration NOT-to determine if better
34
appropriate alternatives/comparators
new vs current drug vs nondrug etc
35
alternatives described
what resources? services? and description of drug dose and so on
36
perspective stated
costs for patients, providers and society
37
type of study
knowing upfront what type of study is being done ..CBA, CMA etc. and why it is appropriate for the study
38
relevant costs
stated perspective for the costs, time period, and justification protocol driven costs should be excluded
39
relevant outcomes
clinically important and appropriate time periods
40
adjustment or discounting
assessing resources over years=use adjusted (standardized) when costs extrapolated more than 1 year out=use discount rate
41
reasonable assumptions
may not be precise or universally agreed upon
42
sensitivity analyses
more reliability (robustness) for discount rates if it supports then your study is more credible
43
limitations addressed
no PE study is perfect limitations: small sample size=disturbs reliability retrospective data collection=disturbs generalization due to potential bias
44
Appropriate generalizations
if used specific population then needs to be specified in the study as a caution against generalizing or extrapolating -age, gender, socioeconomic status, disease state
45
unbiased conclusion
dose study make sense? does the result show no significant difference but the conclusion strongly supports one of the alternatives
46
when analyzing if a good title
answer these: what is being compared? what type of study is being conducted? does the title sound biased?
47
Cost-minimizing analysis (CMA)
pharmacoeconomic analysis that compares the costs of treatments assuming that they have equivalent outcomes
48
CMA compares: bioequivalent
same active ingredients and same desired outcome
49
CMA compares: 2 different settings at the same doses
hospital vs home
50
advantages to CMA
simplest -only costs of intervention are compared easy to convince readers-due to equivalent outcomes
51
Disadvantages to CMA
types of interventions are limited less commonly. used
52
cost analysis
if outcomes are not measured it is a partial economic analysis and not a full one
53
cost-effective analysis
if outcomes are measured it is an cost effective analysis that has the same effectiveness
54
50th percentile
median
55
75th percentile
75 percent of the charges for that service are equal to or less than that fee nationwide
56
healthcare professional cost
costs per minute gross annual salaries including fringe benefits
57
drug administration cost
hospital supply information
58
drug cost of IV and SC formulations
unit cost per treatment cycle US average wholesale price
59
indirect costs
allow for more precise results
60
perspective stated?
what costs were measured? patients, providers,payers, society (may not say directly but if see costs then choose it)
61
relevant costs?
costs were estimated....medical and billing records.....
62
relevant outcomes?
includes time period and same efficacy/scope
63
appropiate generalizations?
does not generalize/extrapolates but says appear to be similar but differences can be seen
64
cost-effectiveness analysis (CEA)
measures costs in dollars and outcomes in natural health units that indicate an improvement in health most common type
65
advantages of CEA
measured in clinical units-familiar and acceptable to clinicians outcomes do not need to be converted to monetary values ex: symptom free days, mmHG, %healed, life years saved, rehospitalizations avoided
66
disadvantages of CEA
only one outcome at a time can be compared so keep to mmHg to mmHG not to FEV interpretation is subjective -is added benefit worth got the added cost
67
uses of CEA
cost of mammogram vs prevention of breast cancer cost of flu vaccine vs. prevention of influenza
68
average cost (Cost effectiveness ratios) CER
total cost/ effectiveness (change % to decimal)
69
marginal costs (incremental cost effective ratios (ICER)
change in costs/change in benefits (effectiveness,outcomes...) (C2-C1) / (E2-E1)
70
for ICER calculation
must use CCA (cost and outcomes) not CER
71
high cost and same effectiveness
not cost effective
72
same cost and higher effectiveness
cost effective
73
lower cost and lower effectiveness
other factors may be considered to determine the winner
74
if less effective at a higher cost
not considered cost effective
75
if more effective at a lower cost
it is considered cost effective
76
if more effective but at a higher cost
decision maker must decide if the higher effectiveness is worth the higher cost (trade off 1)
77
if less effective but at a lower cost
decision maker must decide if the lower cost is low enough to outweigh the lower effectiveness (trade off 2)
78
cost (+) Quadrant A. Quadrant B effect (+) Quadrant C. Quadrant D
quadrant B. is known as Trade off 1-decision maker must decide if the higher effectiveness is worth the higher cost quadrant D= cost effective quadrant A= not cost effective quadrant c= Trade off 2-decision maker must decide if the lower cost is low enough to outweigh the lower effectiveness
79
primary outcomes (final)
not feasible due to lack of time and monetary resources ex: cure of a disease, eradication of an infection, life years saved
80
intermediate outcomes
surrogate outcomes _labs, FEV1, mmHG, A1C
81
efficacy
does the drug work under controlled conditions? RCTS are essential before fda approval
82
effectiveness
does the drug work in routine medical practices? after fda approval
83
efficiency
how well does it work?
84
elasticity
how much the demand changes as the price changes
85
market equilibrium price
the point where the supply and demand curves intersect
86
pharmacoeconomics
description and analysis of the costs of drug therapy to health care systems scientific discipline that evaluates the value of products and services
87
humanistic
consequences of disease/treatment perceived and reported by the PATIENT
88
4 types of direct medical costs
meds, medical services, personnel costs, hospitalizations

Biostats (4 decks)

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