Pharmacoeconomics Flashcards

1
Q

What is the definition of pharmacoeconomics? What is the focus on? What does it address?

A

The field of study that evaluates the behaviour or welfare of individuals, firms, and markets relevant to the use of pharmaceutical products, services, and programs

  • Focus is on inputs (costs) and outputs (outcomes)
  • Addresses clinical, economic, and humanistic aspect of health care interventions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define these key concepts and terminology;

A) Efficiency

B) Opportunity cost

C) Incremental analysis

D) Sensitivity analysis

A

A)

  • Obtaining maximum benefit (i.e. health gain) from limited resources

B)

  • “Benefit foregone when selecting one therapeutic alternative over the next best alternative” –> cost incurred by not enjoying the benefit associated with the best alternative choice

C)

  • The ‘additional’ costs and benefits that arise as a consequence of using new drugs compared to existing drugs

D)

  • Explores the extent to which study conclusions are dependent on underlying assumptions or data that may be subject to error
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define these three terms for costs;

A) Direct

B) Indirect

C) Intangible

A

A)

  • Not just drug costs!
  • All costs paid directly by the ‘payer’ (e.g. health service - including staff costs, capital costs, etc.) – medical services, procedures, hospital admissions, etc.

B)

  • Costs experienced by the patient (or family or friends) or society
  • May include loss of earnings, productivity, leisure time, or cost of travel to hospital, etc.

C)

  • Pain, worry or other distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacoeconomics takes into account costs vs benefits. Costs has been spoken about above. What are benefits and define the following terms of benefits;

A) Natural

B) Associated economic benefit

C) Utility

A

Aims to incorporate all of the impacts upon the patient’s life that arise as a consequence of drug therapy –> may be reported by patient, carer, clinician, or physiological

A)

  • Years of life saved, strokes prevented, cancers cured, hospital admissions prevented, etc.

B)

  • Includes, for example, economic benefits to society because of a patient’s health improving sufficiently to return to work

C)

  • Changes in patient satisfaction or sense of well-being, patient preference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For benefits;

A) What is Quality Adjusted Life Year (QALY)? What is it derived from?

B) What 1 QALY equivalent to

C) What can QALYbe calculated for?

D) What type of method results in QALY benefit measurement?

A

A)

  • Summary of quality and quantity of life – i.e. measure of disease burden
  • Derived from the length of time (in years), multiplied by the utility (full health utility = 1)

B)

1 QALY = 1 year in ‘full health’

  • 0.3 QALY = 0.3 years in full health or 1 year at 30% of full health (utility = 0.3)

C)

  • QALYs an be calculated for any condition or disease, so useful for comparing one disease with another
  • Utility derived from validated questionnaires

> Non-specific (EQ-5D, SF-36) or disease state-specific

> Other methods - Time Trade-Off (TTO) or Standard Gamble

D)

  • Cost-utility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Compare pharmacoeconomic analyses by the different methods (cost-minimisation, cost-effectiveness, cost-utility, cost-benefit)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is ICER? What is the formula?

A

Incremental cost-effectiveness ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For ICER;

A) What happens to interventions in Q3 and Q4?

B) What happens to interventions in Q1 and Q2?

A

A)

  • Rejected or dominated

B)

  • Accepted or dominant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who assesses both clinical effectiveness and cost-effectiveness for PBS subsidization?

A

Pharmaceutical Benefits Advisory Committee (PBAC)

  • Economics Sub-Committee (ESC) advises on cost-effectiveness policies and evaluates cost-effectiveness aspects of major submissions to the PBAC
  • 12 health economics/clinical experts (public health, pharmacy, epidemiology, etc.) + 1 pharmaceutical industry representative
  • Healthcare system perspective adopted
  • Does not generally accept cost-benefit analyses alone
  • Final decision made by Minister for Health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is there a threshold for funding new medicines? What price of an ICER per QALY is more likely to be recommended?

A

No specific threshold for funding new medicines

  • However, a new drug with an ICER < $50 000 per QALY gained is more likely to be recommended.
  • Uncertainty of ICER and timeframe considered
  • Other factors (e.g. clinical need, equity) also considered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly