Health Economics Flashcards
Basics of health economics is?
That we have to utilize opportunity cost and make up our mind of a new therapy has the best value according to other opportunity costs.
Considerations in health economics
- Lives saved
- Quality of life (very subjective and difficult to calculate)
What is horizontal and vertical equity?
Horizontal equity requires that individuals with similar characteristics (i.e. need) of medical relevance to be treated similarly
Vertical equity permits differential treatment of individuals with different characteristics (needs) (think ventilators during covid and a 20 year old vs. 80 year old. It’s more expensive to lose the 20 year old and they get more added value (life years), and thus they get the ventilator)
Describe horizontal and vertical equity in COVID
A lof of vertical equity (younger people getting respirators, vaccines getting to risk groups first, vaccines going to western countries before 3rd world countries, lockdown affecting young people more than old people).
Horizontal equity in testing most of the time.
Cost effectiveness analysis in health economics include what two main concepts?
QALY (Quality Adjusted Life Years) and ICER (Incremental Cost Effectiveness Ratio)
What is a QALY
Quality Adjusted Life Years
What is ICER?
Incremental Cost Effectiveness Ratio – the “Marginal Cost” of an extra life year.
Start with the cheapest option an see how many more QALY’s you can create and at what cost. A = 4K for 6 QALYS, B = 8K for 7 QALY = 1 more QALY for 4K = ICER = 4K.
What is the thing about ICER and domination?
Dominated alternatives are left out
If you have a product that is more expensive and offers less QALYs than several other products, it’s left out.
What is HRQL? And how is it measured?
HRQL - Health-Related Quality of Life
HRQL measured through questionaires
How are QALYs calculated?
QALYs are generated by the summation across all health states of the length of time in a particular health state multiplied by a weight representing the HRQoL attached to that health state
What are incremental QALYs?
The incremental added QALYs between different products when comparing them. Often together with ICER.
How do you make prices in pharma?
Value-based. The more QALY you create the higher the value, the higher the price.
What is the price of a QALY in UK?
20.000 pounds – very public number.
NICE
NHS - National Healthcare System
Are all QALYs treated equally?
No, end of life QALYs have higher prices as they are more valuable than earlier QALYs. Think; You have one year to live, is worth more than a year in “You have 20 years to live”.
Treatments that add QALYs restoring health and sustained over a very long period, burden of illsness and societal impact also are more expensive.
Where is the limit for a QALY based on Pauldon?
NICE has a limit of 20K pounds, Pauldan says that if it is above 13.000 pounds, QALY are lost for other patients.
