Pharmacoeconomics PDF Flashcards by Veronica Robinson

T/F
Medicines account for the majority of total healthcare cost.

False
they are a small but significant proportion

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Some factors causing rising medication prices

new medicines marketed under patent law
drug therapy is preferred over invasive therapy
various off label-uses
irrational prescriptions

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most common therapeutic intervention in medicine

writing a prescription

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Pharmacoeconomics applies principles of health economics and applies them to _____.

pharmaceutical policy

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Economic components of pharmacoeconomics

cost benefit
cost effectiveness
cost minimization
cost utility

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humanistic components of pharmacoeconomics

Quality of life
patient preference
patient satisfaction

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Pharmacoeconomics

the branch of economics that uses:
-cost-benefit
-cost-effectiveness
-cost-minimization
-cost-of-illness
-cost-utility analyses

to compare pharmaceutical products and treatment strategies

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Pharmacoeconomics mainly works on health economics, focusing on…

costs/benefits of drug therapy

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Health outcomes research, and patient-reported outcomes (PRO) in particular, aim at…

understanding patient value (impact of disease and
its treatment on physical functioning and psychosocial
wellbeing) –> “health-related quality of life” (HRQL).

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Health care cost and demand are increasing in all countries due to…

improved/more sophisticated technology

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increased health care spending is due to…

increased life expectancy
increased technology
increased standard of living
increased demand for quality care/services

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Factors that affect drug pricing

1.Sector: private more $
2.Procurement agent type
3.Distribution route: hospital pharmacies may cost more than public health sector distributive system
4.Patient status: patient in force = higher $$ for patented Rx

others:
patented vs generic
retail/wholesale markup
PharmD fees
Changes in population (ie: more old ppl)
MD prescribing habits
Newer drug vs. older

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Why is pharmacoeconomics more important now?

increased emphasis on efficient drug therapies for a disease, which are more costly

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Pharmacoeconomics is a branch of…

health economics

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Pharmacoeconomics results from the health economics discipline coming of age through ___ to ___.

consolidation to disversification

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Pharmacoeconomics
areas of need

-Industry- research/development alternatives.

-Government- program benefits and prices

-Private Sector- Designing insurance benefit coverage

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challenges to the pharmaceutical indutry

-blockbuster drugs going off-patent
-generic competition
-demand for innovative medicines
-rising drug development costs

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T/F
reducing costs and rationing resources is not compatible with the achievement of optimal health outcomes

true
must do cost:benefit analysis for best possible scenario

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how does pharmacoeconomic evaluation reduce monetary burden on the consumers

by insuring global pricing strategy

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Cost types

-financial cost (mandatory cost)
-economic cost (resource for which no mandatory payment is made)
-opportunity cost: benefit foregone when selecting one therapy alternative over the next best alternative

also:
direct, indirect and intangible

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the first step in any cost analysis is…

the identification of the various costs (direct, indirect and intangible)

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Direct Cost

costs from the perspective of the healthcare funder: including staff costs, capital costs, drug acquisition costs

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Indirect cost

not just the patient themselves but also their family and society as a whole

loss of earnings, loss of productivity

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Intangible Cost

pain, worry or other distress

sometimes reflected in quality of life measurement

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Ways cost can be measured

* Cost / unit * Cost / treatment * Cost / person * Cost / person / year * Cost / case prevented * Cost / life saved * Cost / DALY (disability-adjusted life year)

second fundamental component of a pharmacoeconomic study is...

outcomes or benefits (cost benefit analysis)

Expected beenfits from an intervention may be measured in these 2 units...

Natural units: years of lives saved/strokes prevented Utility units: satisfaction; quality of health, not just its quantity

T/F Pharamaeco. eval can be incorporated into clinical trials.

True

Why conduct a pharmaeco. eval into a clinical trial? (5)

1. Pricing of a new drug 2. Repricing of an old drug 3. Convincing a drug formulatory 4. Generation of data for promotional material 5. Mandatory for drug licensing and medical reimbursement (in some countries).

T/F Pharmacoeconomic evaluations include any study designed to assess the costs (resources consumed) and consequences (clinical, humanistic) of newer therapies

False assess consequences of alternative (not newer) therapies

four types of pharmacoeconomic studies.

-Cost-minimization analysis (CMA) -Cost-effectiveness analysis (CEA) -Cost-utility analysis (CUA) -Cost-benefit analysis (CBA)

Cost-Minimization Analysis (CMA)

- comparing multiple drugs of equal efficacy and equal tolerability -comparing 2+ therapeutically equivalent agents or alternate dosing regimens of the same agent -The option that has the least cost is selected

Cost-Minimization Analysis (CMA) cannot be used to evaluate programs or therapies that....

lead to different outcomes (compares equal efficacy/tolerability)

Cost Effective Analysis (CEA)

- aid in the selection of a course of action from various alternative approaches -cost vs. effectiveness (cost/outcome) -CANNOT compare two totally different areas of medicine with different outcomes

most commonly applied form of economic analysis

cost effective analysis (CEA)

ICER

incremental cost-effectiveness ratio

Cost Utility Analysis (CUA)

-drugs/interventions with different outcomes can be compared -good for life-extending Tx w/ serious side effects (e.g., cancer chemotherapy or -reductions in morbidity rather than mortality (e.g., medical treatment of arthritis)

T/F cost-utility analysis (CUA) is the most commonly employed analysis.

false not common lack of agreement on measuring utilities, difficulty comparing QALYs (quality adjusted life years) across patients and populations, and difficulty quantifying patient preferences

When HRQOL (health-related quality of life) is the most important outcome, we use which cost analysis?

Cost utility analysis (CUA)

____ can compare cost, quality, and the quantity of patient-years

Cost utility analysis (CUA)

QALY (quality-adjusted life year) is a common measure of health status used in ____, combining ___ and ___ data.

CUA morbidity mortality

cost-utility ratio (C:U ratio)

ratio is translated as the cost per QALY gained QALY- quality-adjusted life year

QALYs represent...

the number of full years at full health that are valued equivalently to the number of years as experience ex: a full year of health in a disease free patient would equal 1.0 QALY. A year w/ a specific disease might be 0.5

Cost Benefit Analysis (CBA)

- most comprehensive and the most difficult - totally different interventions can be compared -costs and benefits do not occur simultaneously -programs with different objectives

Cost Benefit Analysis (CBA) is expressed in...

as a ratio (a benefit-to-cost ratio), a net benefit, or a net cost

Whats the challenge with Cost benefit analysis (CBA)?

-calculating the benefits in economic term

T/F The cost benefit analysis must always take into account intangible costs.

False CBA may ignore intangible benefits (pain, anxiety, stress) that are difficult to express in monetary terms

precision health economics is a branch of...

health economics

precision health economics helps us...

-choose between two alternatives -compare their clinical benefit on one hand and their cost on the other

Whats the interest of the pharmacoeco. evaluation user?

where and how these results can help them for a better care of their patients do not care about results themselves

3 common types of perspectives in economic studies

producer payer social

Which perspective is the most appropriate for making financial decisions?

society

judgment must be made regarding a new drug's additional benefits are worth the extra costs, therefore, whether it is ___.

cost effective

One of the primary applications of pharmacoeconomics in clinical practice today is to...

aid clinical and policy decision making.

Complete pharmacotherapy decisions should contain assessments of three basic outcome areas whenever appropriate:

economic, clinical, and humanistic outcomes (ECHO)

Pharmacoeconomic data can support various clinical decisions, ranging from the level of the patient to...

the level of an entire healthcare system

application of pharmacoeconomics to decision making is divided into two basic areas:

-drug therapy eval -clinical pharmacy service evaluation

____ of a firm's products may be equated to its corporate value.

QALYs

Applied pharmacoeconomics is defined as

putting pharmacoeconomic principles, methods, and theories into practice to quantify the value of pharmacy products and pharmaceutical care services

helps practitioners justify the value of the products and services

applied pharmacoeconomics

Dutch Guidelines for Pharmacoeconomic Research

designing, conducting and reporting pharmacoeconomic research

Guideline 1 - The perspective of the evaluation The pharmacoeconomic evaluation should be performed and reported from a ____ perspective, in which all costs and benefits are included

societal

Guideline 2 - Choice of comparative treatment/ indication The drug for a certain indication should be compared with ______, or if that does not exist, the usual treatment

the standard treatment

Guideline 3 - Analytical technique If the improvement in quality of life forms an important effect of the drug being assessed, we must perform a ___.

Cost-utility analysis (CUA) if the above is not the case, a CEA must be done (cost-effectiveness analysis)

(Guideline 3) If the manufacturer does not expect the drug to have an added therapeutic value or mutually replaceable with (a) different drug(s), then a ___ can be carried out.

CMA (cost minimization analysis)

Why do we use the Manual for cost research?

promote the uniformity and the standardization of cost measurement and evaluation

Guideline 6 Health states and survival data need to be reported ___.

separately

Guideline 7 The model used is preferred to be ___.

peer reviewed

Guideline 8 The cost-effectiveness of the treatments to be compared is presented by reporting the ___ and ___ between the treatments.

incremental effects and costs

Guideline 9 If data on effects and costs are collected over a period longer than ____, effects and costs must be discounted after ___.

1 year the first year

Guideline 9 How are the costs and effects discounted?

data must be collected over a time period >1 Yr start discounts after the first year primary analysis = 4 % discount onward = 1.5%

Guideline 10 Sensitivity analysis

- formulate an upper and a lower limit for each estimate reflecting the uncertainty margins -examines the effect of simultaneous alterations in various variables -accounts for correlation btwn the variables

Guideline 11 Expert panel

pharmacoeconomic evaluation provided by the expert panel

There's an urgent need to develop a science based on study of ___ and ___ to healthcare system and society.

cost drug therapy

How is pharmacoec. relevant to socioeconomics?

it relates patients, society and economy, to drug therapy

T/F There is a solid concensus in pharmacoeconomic guidelines.

False majority are vague and general no consensus among the developers

Overall recommendation from the authors of the pharmacoeconomics PDF

1. strict guidelines w/ uniform global standards by an independent body (people from academia, industry and health authorities) 2. this would help in reducing the monetary burden on institutions and public