Midterm Reporting Assessment Flashcards
are considered the best source of evidence, used for the purposes of HTA.
systematic reviews w/ or w/o meta-analysis
a systematic way to obtain and document information about an individual’s medical and psychiatric conditions and symptoms, function, behavior, personal history, values, preferences, goals, and other relevant information, and which is then analyzed using clinical reasoning to identify underlying causes of conditions and symptoms and to choose pertinent interventions.
clinical assessment
Purchasing agents:
DOH
PhilHealth
is the estimation of the cost of health interventions
or services in a specific context (i.e., location, time period, population).
Costing
A statement that gives the value of the cost incurred in the manufacturing of finished goods. It helps in fixing the selling price of the final product after charging appropriate overheads and allowing a certain margin for profits.
COSTS ESTIMATION
the comparative analysis of alternative courses of action in terms of both their costs (resource use) and consequences (outcomes and effects) (Drummond et al., 2015).
economic evaluation
In costs estimation, a ___ or ___ approach should be employed.
random or stratified
costs may be estimated through focus group discussions, interviews with providers or patients, examination of patient records, time sheets, direct observation of practice, and work sampling.
Human resource
used to address bias resulting from misreporting or incomplete data should be reported and justified.
Formal analytical approaches`
a method of costing that involves estimating costs without breaking them down into smaller components. This method is often used when a company needs a rough estimate of the cost of a project or product, and does not require a detailed breakdown of costs. It is also known as top-level costing.
Gross costing approach
a method of costing that involves breaking down costs into small, detailed components. This approach is used to provide a more accurate and detailed estimate of the costs of a project or product. It is also known as bottom-up costing.
Micro costing approach
costing methods that start with the detailed costs of individual components and allocate them upwards to arrive at an overall cost. These methods are used to provide a more accurate estimate of the costs of a project or product by taking into account the specific costs of individual components.
Bottom-up allocation methods
costing methods that start with an overall cost and allocate it downwards to individual components. These methods are often used when a company needs a quick estimate of the costs of a project or product, and do not require a detailed breakdown of costs.
Top-down allocation methods
a method of allocating costs that involves assigning costs first to the departments or processes that incur them, and then allocating them to other departments or processes in a step-wise manner. This method recognizes that some costs are incurred by multiple departments or processes, and assigns those costs based on the proportion of the cost that each department or process incurs.
Step-down costing
a method of costing that involves identifying and allocating costs based on the activities that drive them. This method is often used in industries where there are many indirect costs, and where traditional costing methods may not accurately capture the true cost of a product or service. It allocates costs based on the specific activities required to produce a product or service, providing a more accurate estimate of the true cost.
Activity-based costing
this should be avoided because this is likely biased.
Convenience sampling
recall period still provides reliable estimates?
two- to three-months
(resource use)
costs
(outcomes and effects)
consequences
Comparison of health gains and costs. Allows decision makers to make efficient allocation of resources while maximizing health gains.
Cost-Utility Analysis (CUA)
To further characterize the clinical benefit profile of the health technology
Cost-effectiveness analysis (CEA)
Intervention and the comparator are equivalent in terms of
clinically relevant health outcomes.
Cost minimization analysis (CMA)
4 Basic Types of Pharmacoeconomic Analysis:
Cost-minimization analysis (CMA)
Cost-effectiveness analysis (CEA)
Cost-benefit analysis (CBA)
Cost-utility analysis (CUA)
Assumed to be equivalent in comparable groups
Cost-minimization analysis (CMA)
Cost-effectiveness analysis (CEA)
Cost-benefit analysis (CBA)
Cost-utility analysis (CUA)
Cost-minimization analysis (CMA)
Philippine Peso or monetary units
Cost-minimization analysis (CMA)
Cost-effectiveness analysis (CEA)
Cost-benefit analysis (CBA)
Cost-utility analysis (CUA)
Cost-benefit analysis (CBA)
Natural units (life years gained, mmHg blood pressure, mMol/L blood glucose)
Cost-minimization analysis (CMA)
Cost-effectiveness analysis (CEA)
Cost-benefit analysis (CBA)
Cost-utility analysis (CUA)
Cost-effectiveness analysis (CEA)
Quality-adjusted life year (QALY) or other utilities
Cost-minimization analysis (CMA)
Cost-effectiveness analysis (CEA)
Cost-benefit analysis (CBA)
Cost-utility analysis (CUA)
Cost-utility analysis (CUA)
A type of Pharmacoeconomic Analysis where the outcomes are assumed to be equivalent (e.g. same medication different
companies). The study is considered to be a cost analysis, and
therefore not a full pharmacoeconomic analysis.
Cost-minimization analysis (CMA)
economic evaluation technique that compares ‘cost per consequence’ of two or more interventions. It measures outcomes in natural units (e.g., mm Hg, cholesterol levels, symptom-free days [SFDs], years of life saved).
Advantages:
* Easier to quantify.
* Easier to measure.
Disadvantages:
* Inability for comparison (e.g. prothrombin time vs blood glucose measures)
* Difficult to combine (e.g., side effects, impact on other diseases)
Cost-effectiveness analysis (CEA)
type of economic evaluation that can help you compare the costs and effects of alternative interventions.
Advantages:
* Measured based on years of life (1.0 for “perfect health” to 0.0 for dead”).
* Uses one common unit such as the QALY.
Disadvantage:
* Measured base on rough estimate”
Cost-utility analysis (CUA)
incorporate patient or society preferences for specific health states. When morbidity and mortality are both important outcomes of a treatment, CUA should be used to incorporate both into one unit of measure.
utility weights
an economic evaluation technique that compares the cost of the intervention with the benefit incurred, where the benefit is measured by monetary units. Both the costs and benefits are valued in monetary terms.
Advantages:
* Discernable.
* Subject to comparison.
Disadvantages:
* Difficulty in placing monetary value
* Estimates can be imprecise.
Cost-benefit analysis (CBA)
Only a list of costs and a list of various outcomes are presented, with no direct calculations or comparisons.
Cost-consequence analysis (CCA)
The researchers attempt to determine the total economic burden of a particular disease on society. It indicates the magnitude of resources needed for a specific disease or
condition. And determine the market potential for a new product or by payers to set priorities for reimbursement.
There are two categories for COI
1. Direct costs.
2. Indirect costs.
Cost-of-illness analysis (COI)
the process of varying model input values and recording the
impact of those changes on the model outputs.
Sensitivity Analysis
TYPES OF SENSITIVITY ANALYSIS:
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
varying the value of one variable at a time
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
One-way SA
identifying the value a parameter must take to achieve a pre-specified change in incremental cost effectiveness ratio or policy implication.
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
Threshold Analysis
the use of probability distributions to describe parameter values and the use of Monte Carlo simulation to generate
distributions of the expected costs and outcomes, and a distribution for the incremental cost effectiveness ratio
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
Probabilistic SA
varying more than one variable at a time.
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
Multi-way/scenario SA
identifying the impact of setting a parameter at the
highest or lowest possible value.
varying more than one variable at a time.
One-way SA
Multi-way/scenario SA
Probabilistic SA
Threshold Analysis
Analysis of extremes
Analysis of extremes
is implemented by running a modified version of the standard two-level simulation required for Expected Value of Perfect Information.
POSA
the range of values in the distribution of the parameter of interest.
Outer-loop
full PSA (monte carlo simulation) applied to all other parameters in the model whilst holding the value of the chosen parameter fixed.
Inner loop
The range of values sampled are in?
centiles or deciles
STEPS IN PROBABILITISTIC ONE-WAY SENSITIVITY ANALYSIS (POSA):
Select a parameter for POSA
Sample Outer Loop Value for the Parameter.
Run Inner Loop Simulation
Record the conditional expected costs and outcomes for all
strategies.
Return to Step 1 sampling a new Outer Loop value until all values of interest have been evaluated.
Rank the costs and outcomes for each strategy by the
sampled value of the parameter.
Use the ‘reference case’ value of lambda - the cost
effectiveness threshold to calculate the conditional
Incremental Net Monetary Benefit for each sampled value.
* (E2E) (C2- C1) = c INMB
Read-off the probability of each sampled value being
observed from the Probability Density Function used for
the full Probabilistic Sensitivity Analysis.
In POSA, The greater the number of values chosen, the greater the precision.
T/F
T
a measure used in health economics to evaluate the cost-effectiveness of a medical intervention compared to an alternative. It represents the ratio of the difference in costs between the two interventions and the difference in their outcomes. A lower ICER indicates that the intervention is more cost-effective, while a higher ICER indicates that the intervention is less cost-effective.
Incremental Cost Effectiveness Ratio (ICER)
The formula for calculating the ICER is:
ICER = (Cost of Intervention A - Cost of Intervention B) / (Effectiveness of Intervention A - Effectiveness of Intervention B)
use absolute Net Monetary Benefits rather than incremental Net Monetary Benefit. The strategy with the highest Net
Monetary Benefit is always the best value.
POSA FOR EVALUATIONS WITH 3 + STRATEGIES
It is inadequate, at risk of bias, and prone to misinterpretation by decision makers
Conventional (Deterministic) One-way Sensitivity Analysis
Is implemented by running a modified version of the standard
two-level simulation required for Expected Value of Perfect
Information.
POSA
The range of values in the distribution of the parameter of interest.
Outer Loop
Full PSA (monte carlo simulation) applied to all other parameters in the model whilst holding the value of the chosen parameter fixed.
Inner Loop
a form of analytical model, in which distinct branches are used to represent a potential set of outcomes for a patient or patient cohort (York Health Economics Consortium,
2016).
DECISION TREE
are used to model interventions that have few and distinct outcomes that can be measured at a specific time point or over short time horizons.
DECISION TREE
represented by a circle, shows the probabilities of certain results.
Chance nodes
represented by a square, shows a decision to be made
Decision nodes
represented by a triangle, shows the final outcome of a decision path.
End nodes
the application of an analytical method for systematically comparing different decision options. It assists with selecting the best or most cost-effective alternative.
DECISION ANALYSIS
provide a framework to process, and apply follow as you collect, information and evidence to the decision.
DECISION-MAKING MODELS
helps to collect the evidence, process the information, and identify the best way to make decision
DECISION-MAKING TOOLS
STEPS IN DECISION ANALYSIS:
IDENTIFY THE SPECIFIC DECISION
SPECIFY ALTERNATIVES
DRAW THE DECISION ANALYSIS STRUCTURE
SPECIFY POSSIBLE COSTS, OUTCOMES, AND PROBABILITIES
PERFORM CALCULATIONS
CONDUCT A SENSITIVITY ANALYSIS
a choice is allowed
Chance node
Choice node
Terminal node
Choice node
chance comes into the equation
Choice node
Chance node
Terminal node
Chance node
the final outcome of interest for each option in the decision is represented
Choice node
Chance node
Terminal node
Terminal node