Health Economics And Resource Allocation Flashcards
In relation to health economics, what is meant by equity?
The extent to which distribution of resources is fair
In terms of health economics, what is meant by utility?
The value an individual places on a health state
In terms of health economics, what is meant by opportunity cost?
Once you have used a resource in one way, you no longer have it to use in another way
What does QALY mean?
Quality adjusted life years
Composite of survival and quality of life
What does 1 QALY equal?
1 year of perfect health
[assumes that 1 year in perfect health is equal to 10 years with a quality of life of 0.10 perfect health]
You can trade off survival and quality of life, so if 1QUALY= 2 years at 50% QOL for 1 persons. How much time would 2 people have of 100% QOL for that 1 QALY?
6 months
How do you compare QOL with and without treatments using QALYs?
Without treatment: QOL (ie 0.8%)x years (1)=0.8 QALYs
With treatment: QOL (ie 0.2%)x years (4)=0.8 QALYs
Compare the two, here there is no difference.
How do you use QALYs in cost utility analysis? Use the following data to help:
Female has peptic ulcer and can expect to live another 23 years.
QOL w/out T=0.7%
Ta= 0.95% at $50 per annum
Tb= 0.80% at $30 per annum
Which is more cost effective?
W/out T:
0.7% x 23= 16.1 QALY
W/ Ta:
0.95% x 23= 21.85 QALY
Total cost of treatment: 50x23= $1,150
W/ Tb:
0.80% x 23= 18.4 QALY
Total cost of treatment: 30x23= $690
QALYs gained:
Ta: 21.85-16.1=5.75
Tb: 18.4-16.1=2.3
Cost per QALY gained:
(Total cost divided by QALY gained)
Ta: 1,150/5.75=$200 per QALY
Tb: 690/2.3=$300 per QALY
Therefore Ta is more cost effective despite being more expensive
What are some criticisms of QALYs?
Controversy about the values they embody
Do not distribute resources according to need, but according to the benefits gained per unit of cost
May disadvantage common conditions
Technical problems with their calculations
QALYs do not assess impact on carers or family