Pharmacoeconomics

Question 1

Types of economic outcomes (cost)

Answer 1

Cost is value of resources consumed by a program/drug therapy of interest

Direct- medical or non-medical (transport or medications)
Indirect- lost wages
Time- lost due to illness or treatment
Intangible costs - pain or suffering

Question 2

Types of economic outcomes (consequences)

Answer 2

Consequence is defined as effects, outputs, or outcomes of drug therapy

QALY- quality adjusted life years. 0= death, 1= perfect health.

QALY= number of life years remaining x QOL

Question 3

Types of analysis
Explain COI

Answer 3

Cost identification / minimisation
Cost effectiveness
Cost benefit
Cost utility
Net monetary benefit

Cost of illness (COI) - identifies and estimates overall cost of a disease for a population
Measures direct and indirect cost
Not used to compare competing treatment alternatives, but to provide estimate of financial burden

Question 4

Explain CMA

Answer 4

Cost minimisation analysis

Determines of least costly alternative when comparing 2+ treatments
Not difference in outcomes

Alternatives must have equivalent safety and efficacy

Measured in dollars

Question 5

Explain CEA

Answer 5

Cost effectiveness analysis

Estimates differences in costs and differences in outcomes between interventions
E.g. PPI vs H2Rantag in PUD
Cost- dollars
Outcomes- lives saved, life expectancy, bp drop)

Question 6

Explain CUA

Answer 6

Cost utility analysis

Compares different treatments from different pharmacological classes for management of different diseases

Quality adjusted life years used
Best treatment= lowest cost per QALY

Question 7

Explain CBA

Answer 7

Cost benefit analysis
Estimates differences in cost and benefits in same units (money)

Compare two different programs

Expressed as a ratio (benefit-cost), a net benefit, or net cost.

Question 8

Economic study perspectives

Answer 8

Patient perspective- what patient pays

Provider perspective- expense of providing a product or service (hospitals, private-practise physicians)

Payer perspective- insurance companies, employers, or government

Societal - broad

Question 9

Steps in economic evaluation

Answer 9

Step 1- quantify costs of care
Step 2- quantify outcomes
Step 3- assess average costs and outcomes, if they differ among treatment groups
Step 4- compare differences in costs and outcomes and evaluate value of costs
Step 5- perform sensitivity analysis

Question 10

Critical appraisal of economic literature or evidence

Answer 10

Assess technical merit of study, are results applicable to local decision making, do results apply generally in different jurisdictions w/ different perspectives?