Lecture 12 - Pharmacoeconomics of Type II Diabetes Treatment

Question 1

Costing study

Answer 1

Examine how much the disease costs the community per unit time (normally year)

Question 2

Cost effectiveness

Answer 2

Measure outcomes (life years, number of days free of illness) versus cost of treatment

Question 3

What is a cost-effectiveness plane?

Answer 3

Question 4

QALY

Answer 4

Quality-adjusted life years

Question 5

What are quality-adjusted life years?

Answer 5

Compare years to a scale of quality. Scale is 0-1, with 0 being quality equivalent to being dead, 1 being completely healthy

Question 6

Time to first event

Answer 6

Time taken to have first event (EG: Myocardial infarction, stroke). Doesn’t show time between events

Question 7

Why do we need complex models for diseases such as diabetes?

Answer 7

1) In chronic diseases it can take years for the effects of treatments to become apparent. 2) There are many different possible complications and factors influencing the course of disease

Question 8

Original model for diabetes

Answer 8

Eastman model, from mid-1990s

Question 9

Common features of disease models 1) 2) 3) 4)

Answer 9

1) Developed from literature or data regarding what is known of the clinical aspects and epidemiology of disease. 2) A series of health states that are important in terms of costs or impacts on quality of life. 3) Risk factors or treatments that influence the transition to these health states 4) Outcomes measured in quality-adjusted life years, life expectancy

Question 10

What is HbAlc?

Answer 10

A measure of organ glycaemia exposure. A risk factor for type II diabetes

Question 11

In model equations, what does it mean that age is assigned a value of 1.03?

Answer 11

For each year of age, risk of developing diabetes increases 3%

Question 12

Once the data have been put into the model, how is the model run?

Answer 12

P value (probability) of complication is compared to a randomly-generated number between 0 and 1. If it is under the P value, then the model patient is said to have developed the complication.

Question 13

Drug effective in controlling hypertension

Answer 13

Metformin

Question 14

AHEAD study outcomes

Answer 14

Controlling BMI helps in reducing risk of developing diabetes. Once you have diabetes, reducing BMI doesn’t have much effect.

Question 15

What is a hazard ratio?

Answer 15

A number assigned to a factor, EG: age in diabetes risk. Age+1.03, which means that with each year of age, risk of developing diabetes increases 3%

Question 16

What are a high proportion of treatment costs of TIIDM from?

Answer 16

Complications

Question 17

Population that reports the fewest problems with health

Answer 17

Asian.

Question 18

UKPDS

Answer 18

UK prospective diabetes study. A model used to investigate a set of parametric proportional hazard models, using collected data.

Question 19

When do you assume an event happens in a model?

Answer 19

Mid-year

Question 20

Survival function

Answer 20

The probability of dying after an event. Decreases with time after the event

Question 21

Possible new option for treating diabetes

Answer 21

Many drugs for treatment (EG: statins) are coming off patent. These could be used more widely, as they will be much cheaper as generics.