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Pharmacoeconomics > Intro > Flashcards

Intro Flashcards

1
Q

What is the definition of PE?

A

Description & analysis of drug therapy costs to health care systems and society

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2
Q

What is the function of PE?

A

Identify, measure & compare the costs & consequences of pharmaceutical products/services

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3
Q

What is the purpose of outcome research?

A

Assesses the clinical, economic, and humanistic outcomes associated with a product or service

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4
Q

What are the types of outcomes?

A
  1. Clinical
  2. Economic
  3. Humanistic
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5
Q

What are clinical outcomes?

A

Results of treatment with a drug (prevention or cure, ADR, toxicity)

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6
Q

What are economic outcomes?

A

Costs associated with a therapy (labor, equipment, monitoring)

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7
Q

What are humanistic outcomes?

A

Involves patients’ POV (patient’s feeling and perceptions)

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8
Q

What is cost analysis?

A

Studies related to a product or service’s cost

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9
Q

What are clinical/outcome analysis?

A

Studies related to the outcomes that result from a product or service

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10
Q

What does PE study?

A

Both costs and outcomes related to a product or service

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11
Q

When will HCP use PE?

A

To assess and determine if the benefits from the new product or service is worth the additional cost to provide at their facility

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12
Q

What type of services or new products are usually added to pharmacies, hospitals, or clinics?

A
  1. Add an additional healthcare cost
  2. Carry minimal benefit over current treatments or services
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13
Q

Describe the importance of PE?

A

TO understand how to manage limited resources most effectively and efficiently

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14
Q

What are the benefits of PE?

A

Doing more with less achieving the best outcomes with limited resources

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15
Q

What type of data is important for decisions related to healthcare?

A
  1. Appropriate drug selection for hospital or insurance formulary
  2. Management strategies for certain disease states (guidelines)
  3. Appropriate drug selection to treat patients’ medical conditions
  4. Implementation of new services within a pharmacy, hospital, or clinic
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16
Q

How does healthcare providers use PE?

A

Aim to provide optimal patient care to help patients achieve the best outcome

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17
Q

How does insurance payers use PE?

A

Manage rising costs by assessing costs, safety, efficacy, and effectiveness of all treatment options

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18
Q

How does PE bridge the gap between health care and insurance?

A

To estimate the value of patient outcomes received for the money spent on medications and other healthcare products & services

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19
Q

How is the individual patient affected by PE?

A

HCP assess each patient based on factors to determine best treatment plan

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20
Q

How does PE affect patients on a community level?

A

Implementing a new service at hospitals or pharmacy, admins would assess the costs and values for providing new services

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21
Q

What are factors that are assessed in PE? Examples?

A
  1. Probability: reimbursement minus costs for pharmacists to provide vaccinations at pharmacy
  2. Improved patient outcomes: CCM, RPM, Services could reduce the costs of other $$$ services
  3. Improved quality of care: adding a clinical pharmacist to the healthcare team, Improved quality measures for primary care providers
22
Q

How does PE affect patients on a population level?

A

health-system, managed care orgs, or gov plans

23
Q

In what ways do HCP collaborate to establish effective therapies or patient populations?

A
  1. Development of drug formularies and patient copayments (tier system)
  2. Development of drug-use guidelines (step therapy)
24
Q

What is a step therapy?

A

Trial of less expensive meds failed before coverage of expensive options

25
Q

What is the function for government programs?

A

Pay for insurance coverage for citizens using taxes → assess costs and values for treatment options

26
Q

What are additional levels of control government programs may implement?

A
  1. Price negotiation
  2. Price setting
  3. Formulary management
  4. National level
27
Q

Describe the tiers of Medicare Part D?

A
  1. Generic (cheap)
  2. Brand name with medium co-pay
  3. Non-preferred, higher co-pay
  4. Specialty drugs, may require coinsurance to cover high copay
28
Q

What does cost minimization analysis measure?

A

Unit: dollars
Measures: assumed to be equivalent in comparable group analysis

29
Q

What does cost benefit analysis measure?

A

Units: Dollars

Dollars

30
Q

What does cost effectiveness analysis measure?

A

Unit: dollars

Measures: Natural units (life yrs, mmHg, mmol/L)

31
Q

What does cost utility analysis measure?

A

Unit: Dollars

Measures: quality adjusted life year (QALY) or other utilities

32
Q

What is the function of CMA?

A
  1. Cost measured in dollars
  2. Outcomes assumed to be equivalent

All outcomes are expected to be equal, but costs are NOT equal.

33
Q

What type of study?

Comparison of therapeutically equivalent medications.

A

CMA

34
Q

What type of study?

Comparing the costs (inputs) of implementing a PK consulting or diabetes clinic with the cost savings (outcomes) associated with the service.

A

CBA

35
Q

What type of study?

Assessing costs & utilities of two common chemotherapy regimens for non-small cell lung cancer.

A

CUA

36
Q

What type of study?

Inpatient versus outpatient use of prostaglandin E2.

A

CMA

37
Q

What types of study?

BCBS-MS assesses the addition of a new blood glucose-lowering medication to its preferred formulary. The newly approved medication has a greater effect on reducing blood glucose than the current preferred agent, but the daily dose of the new medication is more expensive.

A

CEA

38
Q

What are the advantages of CMA?

A

Simple study to use, as outcomes are not measured

39
Q

What are the disadvantages of CMA?

A

Study can only be used when outcomes are assumed to be equal

40
Q

What is the function of CBA?

A

Measures both costs (inputs) and outcomes in dollars

41
Q

What are the advantages of CBA?

A
  1. HCP can assess whether the benefits of products will exceed cost
  2. HCP can compare multiple products or services with different outcomes
  3. Objectively assess costs and benefits of implementing new products or services

Ratio > 1 = cost-beneficial
Ratio < 1 = not cost-beneficial

42
Q

What are the disadvantages of CBA?

A

Difficult to assign a monetary value on health outcomes (estimates, multiple methods)

43
Q

What is the most common PE analysis in pharmacy lit?

A

CEA

44
Q

What is the function of CEA?

A
  1. Measures cost in dollars
  2. Measures outcomes in natural units (SFD, mmHg, mg/dL, lives saved)
45
Q

What are the advantages of CEA?

A

Outcomes are easier to quantify because health units are commonly used by HCP in RCT and routine clinical practice

46
Q

What are the disadvantages of CEA?

A

Alternatives in comparison must have outcomes that are measured in the same units

47
Q

What type of study?

Evaluation of chemotherapy agents (i.e., number of life years gained).

A

CEA

48
Q

What is the function of CUA?

A
  1. Measures costs in dollars and outcomes in health utilities
49
Q

What the purpose of QALY?

A

Quality-adjusted life year

Healthy utility that accounts for patients’ quality and quantity of life

50
Q

What are the advantages of CUA?

A

Different health outcomes can be compared using one common unit without assigning a monetary value to the outcome
2. Used when morbidity and mortality are important health outcomes associated with a treatment

51
Q

What are the disadvantages of CUA?

A

Difficult to determine an accurate QALY value

Pharmacoeconomics (9 decks)

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