pharmacoeconomics

Question 1

Opportunity Cost

Spending is inevitable, choice is inevitaable

Answer 1

TIME, MONEY
Constant need (for providers) to evaluate patient care choices  and act on them

Patients Choice– Medication vs vacation

Question 2

Pharmacoeconomics and outcomes research

Answer 2

Enhance quality of practice by aiding decision making.
Practitioner in driver seat (mitigates Marketing)
Sets practice priorities
Enhances practitioner position C payor payor
strong evaluation process
> delivery and value in patient care

Question 3

Economics

Answer 3

How people choose to use scarce resources with alternative uses in provision of commodities for comsumption.

Question 4

Value is goal of practice

3 A’s

Answer 4

Minimize cost/benefit ratio= creates value
best return on investment = value
Enhances ability to deliver product for > patient compliance
Acceptable clinical outcomes
Acceptable humanistic outcomes
Acceptable economic outcomes

Question 5

Perspective Point of View

Answer 5

Provider - Outcomes
Patient -Outcomes, Price
Payor- Price, Outcomes
Society- Costs

Question 6

Cost effectiveness

Answer 6

Use of scarce resources to get best value on market.

Question 7

Cost effectiveness

Compares Drug to Drug

Answer 7

Cost of drug
_________ = Cost per unit of effect

Resulting effect

Question 8

Cost per unit of effect

Answer 8

cost 160 x 0.40= decrease in LDL 64 PTS

cost /effectiveness = 160/64 = cost per unit of effect = 2.5 $ per each point decrease in LDL

Question 9

Average cost effectiveness

Answer 9

Best value with outcomes met

Question 10

Agent A average cost effectiveness
$1.00 per /unit
Agent B
$1.60 per /unit

Answer 10

Agent A best value with outcomes met.

Question 11

Incremental cost effectiveness

Answer 11

Compares drug
other theraputic options
standard of care
no treatment ( placebo)

Question 12

Incremental Cost effectiveness

Answer 12

(cost of option B) - (cost of option A)
_________________________________

(effect option B) - (effect option B)

 = Cost to achieve 1 unit of effect

Question 13

Option B crestor, Option A Pravastatin

Answer 13

120-4 116
_______ = ____ = $ 5.80 each unit of effect
60-40 20

Question 14

Evaluate- t Option B crestor, Option A Pravastatin

Answer 14

Agent A -lower cost /effectiveness– decrease cost effectiveness of Agent B- Agent B is of poorer value

Question 15

Pharmacoeconomic Literature evaluation

Evaluation

Answer 15

Quality of Journal
Author qualification
Title ? Abstract Un biased
Study methodology
Sponsorship ---question Bias
Incremental results -
 conclusion &, differences in subgroups
& degree  uncertainty (allowance) could change conclusion.

Question 16

Economice in NP workplace

Answer 16

POLICY
Formularyb decision making
BEDSIDE
Clinical decision making Acute and Chronic

Question 17

KNOW Principle

Treatment of Pain secondary to OA

Answer 17

Pain =
significant disability
significant resource utiliaztion
(affects 15% of population & results in > 100,000 hospitalizations annually)

Question 18

Treatment of pain secondary to OA (2)

Answer 18

Effective pain relief  in OA
 NSAIDS 
     24-30% cheaper 
     > non dyspeptic effects
        symptomatic ulcers, ulcer hemmorhage, 
        & ulcer perforation
Cox II Inhibitors
      > expense than generic NSAIDS
      < GI side effects

Question 19

Treatment of pain secondary to OA (3)

Answer 19

Patient treatment?  NSAIDS  vs COX II
Cost effectiveness prevention of GI Bleed?
COX II =
       15%,< dyspeptic s/s
        50%< in ulcer complication
Not all pts are at risk for GI bleed-
   justification of GI protection?
   ? Value related to extra cost

Question 20

Treatment of pain secondary to OA (4)

Answer 20

< GI risk is valuable for patients with a hx of GI Bleed+ COx II
< risk of GI Bleed is not valuable for patients with without a hx of GI Bleed= NSAID