Economic Evaluation

Question 1

What is a QALY?

Answer 1

• Quality adjusted life year
• Combines quality of life with quantity of life
• calculated by number of years added to life x Health related quality of life score following treatment
• are used in CUA to help prioritise resources by comparing the cost per QALY

Question 2

What are the 4 methods of economic evaluation

Answer 2

CMA- look at cost only
CEA - costs in terms of money, benefits in natural units
CUA - costs in terms of money, benefits in terms of QALY’s.
CBA - cost monetary, benefits natural units converted into money

Question 3

What is an EQD-5? What is it used for ?

Answer 3

Standardised Quality of life measure
Questionnaire
5 dimensions - mobility, self-care, usual activities, pain and discomfort , anxiety and depression
Also a VAS
Used to measure quality of life
Produces health utilities

Question 4

QALY league tables?

Answer 4

Provides a clear way to rank health care interventions for prioritisation in terms of how much health benefit they provide measured by QALY’s.
Helps Policy makers make decisions/choices in terms of resource allocation and prioritisation

Question 5

QALY Calculation

Answer 5

Number of life years gained x quality of life unit =

E.g

(2x0.5) + (2x0.6) =2.2

Question 6

ICER

Answer 6

Cost (A) - cost (b)
————————-
Effect (a) - effect (b)

A = current standard care
B= new intervention

Question 7

Name 3 Direct methods of measuring health states

Answer 7

Standard gamble
Time trade off
Visual analogue

*Direct measurement studies are best for valuing specific side effects or models of drug administration *

Question 8

Categories of cost

Answer 8

Direct medical - staff, equipment, drugs
Direct non-medical - incurred by patients and families
Indirect - loss of production due to absence in work
Intangible - psychological

Question 9

Cost Minimisation Analysis CMA

Answer 9

Benefits are equal
Only considers costs

Question 10

Cost Effectiveness Analysis CEA

Answer 10

• Costs are compared with treatments tho at have a common goal
  Concerned with technical efficiency
• measures health in natural units
• ICER

Question 11

Cost Utility Analysis CUA

Answer 11

• unit of effect is ‘utility’.
• measures both quality and quantity
• preferred by NICE
• concerned with QALY’s
• NICE will only pay if ICER is less that £20,000 per QALY

Question 12

Cost Benefit Analysis CBA

Answer 12

• compares costs and benefits in monetary terms
  Benefits measures in natural units and converted into monetary terms
• concerned with allocative efficiency
• optimal amount to spend is where total cost and total benefits are furthest apart

Question 13

Purpose of economic evaluation?

Answer 13

• to consider scarcity of resources and opportunity costs
• weighing up this or that

Question 14

Sensitivity analysis

Answer 14

Probabilistic
Scenario analysis
Tornado diagram
Threshold analysis

Question 15

Indirect methods of utility measurement

Answer 15

EQD5
SF-6D
HUI