Intro to Pharmacoeconomics Flashcards
Pharmacoeconomics
description and analysis of the costs and consequences of pharmaceuticals and related services
process of identifying, measuring, and comparing the costs, risks, and benefits of programs, services, or therapies
determining the outcomes from the perspective of pts, the HC system, or society
Health consumption expenditures comparison between US and comparable country avg
US spends way more on health care than anyone else as a percent of gross domestic product
however, our life expectancy is lower than the comparable country average “not getting the bang for our buck”
Why is this important
HC costs increasing - US spends more
HC outcomes are declining in US
drug are expensive
trade off considerations on how to spend resources
Classifying costs
calculated to estimate the resources used in the production of an outcome
four types of costs: direct medical costs, direct non-medical costs, indirect costs, intangible costs
Direct medical costs
medical costs for providing treatment
ex. cost of meds, physician visits, hospitalizations
Direct non-medical costs
costs to patients/family directly associated with treatment, but not medical in nature
ex. cost of transportation to clinic, babysitter, food/lodging if out of town
Indirect costs
costs that result from loss of productivity because of illness or death
do not involve a transfer of money
ex. missed work or school days, decreased productivity
Intangible costs
costs of pain, suffering, anxiety, or fatigue due to an illness or treatment of an illness
difficult to measure and assign value
Types of perspective
patient, institution, payer, society
perspective described whose costs are relevant based on the purpose of the pharmacoeconomic study
Pharmacoeconomic analyses
four types: cost minimization analysis (CMA), cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-utility analysis (CUA)
cost measured in $
categorized based on method to assess outcomes
Cost minimization analysis
used to comapre costs of interventions with equivalent clincial outcomes
ex. generic vs brand name drug; drug A vs drug B assuming equal efficacy and safety
How do you measure the total direct costs of a drug
drug A vs drug B assuming equal efficacy and safety
cost of drug + cost of preparation + cost of administration = total cost of drug
CMA cost measurement unit and outcome measurment unit
cost measurment unit: $$
outcome measurement unit: not measured, assumed to be equivalent
CMA advantages and disadvantages
advantages: simplicity, no assessment of outcome
disadvantages: only useful when outcomes are equal
Cost benefit analysis
measures costs of interventions and outcomes in monetary units
determines which intervention provides the best monetary benefit: can be used to compare diff drugs or services for diff outcomes
must assign monetary outcome to clinical endpoints: ex. what’s the cost-benefit of a pharmacy service compared to usual medical care on reducing BP
CBA cost measurement unit and outcome measurement unit
cost measurment unit: $$
outcome measurement unit: $$
CBA advantages and disadvantages
advantages: allows comparison of interventions with diff outcomes
disadvantages: requires assigning monetary value to pain, suffering, life
Cost effectiveness analysis
measures outcomes in natural health units: ex. infections cured, lives saved, # of life years saved
determines with intervention achieves a given objective at the lowest cost: used to compare diff interventions using same measured outcome
most common type of analyses
Incremental cost-effectiveness ration (ICER)
additional cost required to obtain the additional effect gained by switching from drug A to B
ICER = (total cost of drug A - total cost of drug B)/(outcome of drug A - outcome of drug B)
CEA cost measurment unit and outcome measurement unit
cost measurement unit: $$
outcome measurement unit: natural related units
CEA advantages and disadvantages
advantages: outcomes measured in units that are understanable to many clinicians; no need to convert outcomes into dollar amoung
disadvantages: outcomes must be measured in same units; length of life is not the same as quality of life
Cost-utility analysis
measures the outcomes in terms of the quality of the outcome produced
examines the cost of an intervention and the value of the outcome: value = cost + quality
referred to as utility units: often uses pt preferences or functional status; most common outcome is quality-adjusted life years
QALY takes into account
both the quantity and the quality of life generated by HC interventions
product of life expectancy and a measure of the quality of years remaining: 4 years in health state 75% –> 4(0.75) = 3 QALYs
CUA cost measurment unit and outcome measurement unit
cost measurment unit: $$
outcome measurement unit: quality-adjusted life years or other utility measures
CUA advantages and disadvantages
advantages: accounts for both quantity and qaulity of the outcome
disadvantages: not a precise measure, viewpoint may bias outcome measures
Role of the pharmacist
evaluating pharmacoeconomic literature
apply results to clinical decision making: individual pt care, formulary/utilization management, resource allocation/price setting
assist in design/implementation of research studies
