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4151 > HTA (public) > Flashcards

HTA (public) Flashcards

1
Q

what is hta

A

multidisciplinary process that uses explicit methods
to determine the value of a health technology at different points in its lifecycle

.

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2
Q

dimensions of value to be assessed

A

clinical effectiveness, safety, costs, and economic implications

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3
Q

additional dimensions of value that may be assessed

A

ethical, social, cultural, legal and organisational and environmental aspects.

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4
Q

how to do hta

A

Globalise the evidence
Localise the decision

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5
Q

how to localise the decision to sg?

A
  1. Selection of relevant comparator
  2. Cost-effectiveness in local context/health system
  3. Ethical issues
  4. Access issues
  5. Consumer preferences
  6. Workforce planning
  7. Training/credentialing users of technology
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6
Q

what does pico stand for

A

patient/population
intervention
comparator
outcome

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7
Q

what is CMA

A

If there is no significant difference in efficacy and safety, the cheapest option is
preferred i.e. cost minimisation analysis (CMA)

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8
Q

what is CEA

A

If a new technology is superior in outcomes but is likely to result in additional cost to
the health system, cost effectiveness analysis (CEA) is conducted.

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9
Q

what is ICER

A

Incremental cost-effectiveness ratio (ICER) – incremental change in costs divided by
incremental change in health outcomes of a new technology compared to the current
standard of care over a period of time

ICER =
CostA − CostB/EffectA − EffectB (incremental cost per unit outcome)

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10
Q

what outcome should be considered in hta?
1. Safety profile
2. Delays in progression
3. Improved compliance with the new technology
4. Lengthening of life
5. New mechanism of action

A

1,2,4

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11
Q

what are indirect treatment comparisons

A

making use of RCTs that have a common comparator
eg. RCT1: A and B
RCT2: B and C
to determine effectiveness between A and C

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12
Q

transitivity assumption

A

no systematic differences between available comparisons, control groups are sufficiently similar

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13
Q

minimal clinically important difference

A

smallest difference in score in domain of interest which patients perceive as beneficial

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14
Q

what is the health outcome of CUA

A

QALY

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15
Q

what does CEA consider

A

cost and health outcomes

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16
Q

2 components of CMA

A

equieffective doses (proposed medicine and comparator),
direct medicine cost (cost of proposed medicine vs cost of comparator)

17
Q

what is bill size

A

patients out of pocket payment after subsidies

18
Q

what is cost

A

Price at which the public healthcare institution (PHI) procures from manufacturer or distributor

19
Q

what is charge

A

Price which includes any profit margins applied by the PHI (‘cost-plus’ model) and reflected on
patients’ bill
* This price is before any deductions for government subsidies, insurance payouts,

20
Q

are societal costs included in CEA?

A

no

21
Q

markov model assumption

A

future state depends only on the present state, ‘memoryless’

22
Q

long time horizon benefit vs disadvantage

A

benefit: captures all health effects and costs
disadvantage: increases uncertainty

23
Q

short cycle length benefit vs disadvantage

A

benefit: increases precision
disadvantage: reduces efficiency

24
Q

what are utility weights

A

incorporates no. of life years and QOL

25
Q

what are vignettes for measuring health

A

qualitative descriptions of health state to be valued

26
Q

ways to measure health

A
  1. direct patient elicitation
  2. generic preference based measures of health
  3. disease specific measures of health
  4. vignettes/scenarios
27
Q

price volume agreement benefit

A

payment back in rebates for spending above pre-negotiated caps

28
Q

problems when countries uphold explicit CE threshold

A
  • drugs with supposedly lower ICER get raised by companies to maximise profit
  • lack of long term data to determine ICER
  • ignores budget constraints
29
Q

major criteria in decision making of drug subsidies

A
  • clinical need
  • overall benefit
  • cost effectiveness
  • cost of technology and estimated number of patients to benefit
30
Q

characteristics of rwd

A
  • observational
  • unstructured and inconsistent due to variations in data entry
  • large volume of data
  • lack key endpoints for analysis
  • subject to bias and measurement errors
31
Q
A

4151 (3 decks)

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