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Evidence Based Pharmacotherapy > Final > Flashcards

Final Flashcards

1
Q

Costs

A

The value of the resources consumed by the program

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2
Q

Consequences

A

The effects, outputs, and outcomes of the program or treatment alternative

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3
Q

Pharmacoeconomics

A

A full evaluation of the costs and consequences differentiates pharmacoeconomics from traditional cost containment strategies and drug use evaluations

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4
Q

Cost vs price vs charge

A

Cost is magnitude of resources consumed in producing a good or service
Charge is what provider asks to be paid- like price
Reimbursement is what is actually paid

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5
Q

Cost categories

A

Direct
Indirect
Intangible

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6
Q

Direct cost

A

Resources consumed

Involves a transfer of money

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7
Q

Direct medical costs

A

Costs from the fundamental transactions associated with medical care.

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8
Q

Direct nonmedical

A

Exchange of money for something that is not medical care

Example- pay taxi to get to hospital

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9
Q

Indirect cost

A

Unpaid resource commitment
No money is exchanged
Productivity cost

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10
Q

Indirect medical cost

A

Costs that result from the morbidity and mortality of the illness.
Costs ranges in productivity that result from disease or health care interventions.
Missing work, lost productivity

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11
Q

Fixed cost

A

Overhead costs that are relatively constant that nod readily influenced
Heat, rent, lighting
Often not included

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12
Q

Intangible costs

A

Costs of pain, suffering, anxiety, or fatigue that can occur because of an illness or treatment of illness

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13
Q

What type of cost is drugs?

A

Direct medical

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14
Q

What type of cost is babysitting for the children of a patient?

A

Direct nonmedical

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15
Q

What type of cost is a decrease in lost time from work?

A

Indirect medical

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16
Q

What type of cost is a lab test

A

Direct medical

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17
Q

What type of cost is a pharmacist salary?

A

Direct medical

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18
Q

What type of cost is improvement in sleep awakening

A

Intangible

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19
Q

What type of cost is travel costs to clinic

A

Direct nonmedical

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20
Q

What type of cost is physician time/salary

A

Direct medical

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21
Q

What type of cost is advertising for medical service

A

Direct nonmedical

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22
Q

What type of cost is medical supplies

A

Direct medical

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23
Q

What type of cost is less anxiety from asthma attacks

A

Intangible

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24
Q

Resources for cost estimations

A

Measured directly
Retrospectively from medical records or reimbursement claims
Standard lists of costs

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25
Q

Average wholesale price (AWP)

A

List price, typically higher than what is actually paid by pharmacies

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26
Q

Average manufacturers price (AMP)

A

Calculated to reflect the amount paid to manufacturers by wholesalers
Proprietary information

27
Q

The RedBook

A

Printed AWP info annually

28
Q

Medical Services Cost Resources

A

Reimbursements rates

Physicians fee reference

29
Q

Medicare Reimbursement

A

Varies by state

HCPCS

30
Q

Personnel cost resources

A

Time spent performing activity multiplied by salary and fringe benefits
Work measurement methods (stopwatch, logs, etc)

31
Q

How to measure personnel time costs?

A

Work sampling- observations made at pre-selected times
Stopwatch time study- how long to complete an activoty
Work logs
National compensation survey, bureau of labor statistics (wages)

32
Q

How do you measure hospital services?

A

Per diem- sum all costs divided by number of patient days

Per diem but seperate out routine services and ancillary services

33
Q

Hospitalization cost resources

A

Disease specific per diem

Diagnosis-related groups (DRG)

34
Q

Perspective

A

The point fo view from which the economic analysis is performed

35
Q

Societal perspective

A

Broadest
All direct and indirect costs
Most comprehensive but difficult and time consuming to conduct

36
Q

Patient perspective

A

What the patient pays not covered by insurance.

Morbidity and mortality

37
Q

Hospital perspective

A

Typically the perspective used to make formulary or drug use policy changes

38
Q

Insurer perspective

A

Included cost to third-party plan
Typically only direct costs
Government

39
Q

What was the perspective of a paper measuring the cost of depression that gives you direct costs (outpatient, inpatient, medication), indirect costs, and morbidity costs?
None of the costs are coming from the patient.

A

Societal

40
Q

Adjust for timing

A

Time associated with money

Do you want 1000 today or in 5 years?

41
Q

Standardization- bringing the past costs to the present

A

Multiply the costs for each year by the medical inflation rate for that year
CPI
From bureau of labor statistics

42
Q

Discounting-Bringing future costs to present

A

Discount factor is the number by which a future cash flow to be received at time T must be multiplied in order to obtain the current value

43
Q

If the discount rate is 5%, what is the discount factor for 2 years?

A

1/(1+0.05)^2= 0.907

44
Q

So with a higher discount rate, is the money worth more or less in 2 years?

A

less

45
Q

Sensitivity analysis

A

Model using different assumptions

Which discount rate to use?

46
Q

CMA

A

If outcomes not measured, maybe only partial economic analysis?
If measure outcomes and they are equivalent, then CEA

47
Q

Cost Benefit Analysis (CBA)

A

A form of economic evaluation Dollar values for inputs and outputs (outcomes)
Maximizes benefit of investment
Assumes limited resources

48
Q

Theoretical roots for CBA

A

Comes from welfare economics and incorporates individual preferences and values to improve social welfare

49
Q

Advantages of CBA

A

Measuring both costs and benefits in monetary has two main advantages:
Decision makers can determine whether the benefits of a program or intervention exceed the cost and can compare multiple programs/interventions with similar or unrelated outcomes

50
Q

Step 1 of CBA

A

Clearly identify the intervention, program, therapeutic regimen and research to be evaluated.
Also identify alternatives, what is the program being compared to? This is the biggest source of bias!

51
Q

Step 2 of CBA

A

Identify and value all of the resources consumed or costs of providing each intervention

52
Q

Step 3 of CBA

A

Identify and value all of the benefits of providing the intervention program or regimen.
Assign dollar values to all of it.

53
Q

Measuring benefits in CBA

A

Direct benefits are averted direct medical or nonmedical costs
Indirect benefits are averted indirect medical costs
Human capital approach

54
Q

Step 4 of CBA

A

Net benefits= total benefits/total costs
If B/C >1= benefits exceeds costs
Present results

55
Q

Human capital approach

A

One method to measure indirect benefits
HC approach quantifies the productivity loss (=wage)
Goes back to the welfare theory, what you participate to society matters

56
Q

Human capital approach components

A

Wage rate

Missed time because of illness

57
Q

Advantages to human capital approach

A

Straightforward
Easy to use
Days lost from work easily obtained
Income estimates available

58
Q

Disadvantages of human capital approach

A

Biased against the unemployed
HC assumes the value of health benefits equals the economic productivity they permit.
Does not incorporate values for pain and suffering if it does impact productivity

59
Q

Willingness to pay

A

Method that can value both the indirect and intangible aspects of a disease
Determines how much people are willing to pay to reduce the chance of an adverse health outcome

60
Q

Advantages of WTP

A

Places a dollar value on benefits

61
Q

Disadvantages of WTP

A

Validity is questioned
Difficult for patients
Compliance bias-overstating WTP
Strategic bias- understating WTP

62
Q

WTP contingent valuation

A

What are you willing to pay for this intervention?

63
Q

CEA

A

Cost effeciveness
Cost measured in dollars
Consequences measured in disease (lives saved, cases cured, etc.)
Results are cost-effectiveness ratio

Evidence Based Pharmacotherapy (3 decks)

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