Pharmacoeconomics PDF Flashcards

1
Q

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

A

False
they are a small but significant proportion

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2
Q

Some factors causing rising medication prices

A

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

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3
Q

most common therapeutic intervention in medicine

A

writing a prescription

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4
Q

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

A

pharmaceutical policy

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5
Q

Economic components of pharmacoeconomics

A

cost benefit
cost effectiveness
cost minimization
cost utility

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6
Q

humanistic components of pharmacoeconomics

A

Quality of life
patient preference
patient satisfaction

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7
Q

Pharmacoeconomics

A

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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8
Q

Pharmacoeconomics mainly works on health economics, focusing on…

A

costs/benefits of drug therapy

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9
Q

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

A

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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10
Q

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

A

improved/more sophisticated technology

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11
Q

increased health care spending is due to…

A

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

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12
Q

Factors that affect drug pricing

A

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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13
Q

Why is pharmacoeconomics more important now?

A

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

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14
Q

Pharmacoeconomics is a branch of…

A

health economics

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15
Q

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

A

consolidation to disversification

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16
Q

Pharmacoeconomics
areas of need

A

-Industry- research/development alternatives.

-Government- program benefits and prices

-Private Sector- Designing insurance benefit coverage

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17
Q

challenges to the pharmaceutical indutry

A

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

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18
Q

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

A

true
must do cost:benefit analysis for best possible scenario

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19
Q

how does pharmacoeconomic evaluation reduce monetary burden on the consumers

A

by insuring global pricing strategy

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20
Q

Cost types

A

-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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21
Q

the first step in any cost analysis is…

A

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

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22
Q

Direct Cost

A

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

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23
Q

Indirect cost

A

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

loss of earnings, loss of productivity

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24
Q

Intangible Cost

A

pain, worry or other distress

sometimes reflected in quality of life measurement

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25
Q

Ways cost can be measured

A
  • Cost / unit
  • Cost / treatment
  • Cost / person
  • Cost / person / year
  • Cost / case prevented
  • Cost / life saved
  • Cost / DALY (disability-adjusted life year)
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26
Q

second fundamental component of a pharmacoeconomic study is…

A

outcomes or benefits (cost benefit analysis)

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27
Q

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

A

Natural units: years of lives saved/strokes prevented

Utility units: satisfaction; quality of health, not just its quantity

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28
Q

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

A

True

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29
Q

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

A
  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).
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30
Q

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

A

False
assess consequences of alternative (not newer) therapies

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31
Q

four types of pharmacoeconomic studies.

A

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

32
Q

Cost-Minimization Analysis (CMA)

A
  • 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

33
Q

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

A

lead to different outcomes

(compares equal efficacy/tolerability)

34
Q

Cost Effective Analysis (CEA)

A
  • 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

35
Q

most commonly applied form of economic analysis

A

cost effective analysis (CEA)

36
Q

ICER

A

incremental cost-effectiveness ratio

37
Q

Cost Utility Analysis (CUA)

A

-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)

38
Q

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

A

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

39
Q

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

A

Cost utility analysis (CUA)

40
Q

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

A

Cost utility analysis (CUA)

41
Q

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

A

CUA
morbidity
mortality

42
Q

cost-utility ratio (C:U ratio)

A

ratio is translated as the cost per QALY gained

QALY- quality-adjusted life year

43
Q

QALYs represent…

A

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

44
Q

Cost Benefit Analysis (CBA)

A
  • most comprehensive and the most difficult
  • totally different interventions can be compared
    -costs and benefits do not occur simultaneously
    -programs with different objectives
45
Q

Cost Benefit Analysis (CBA) is expressed in…

A

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

46
Q

Whats the challenge with Cost benefit analysis (CBA)?

A

-calculating the benefits in economic term

47
Q

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

A

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

48
Q

precision health economics is a branch of…

A

health economics

49
Q

precision health economics helps us…

A

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

50
Q

Whats the interest of the pharmacoeco. evaluation user?

A

where and how these results can help them for a better care of their patients

do not care about results themselves

51
Q

3 common types of perspectives in economic studies

A

producer
payer
social

52
Q

Which perspective is the most appropriate for making financial decisions?

A

society

53
Q

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

A

cost effective

54
Q

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

A

aid clinical and policy decision making.

55
Q

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

A

economic, clinical, and humanistic outcomes (ECHO)

56
Q

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

A

the level of an entire healthcare system

57
Q

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

A

-drug therapy eval
-clinical pharmacy service evaluation

58
Q

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

A

QALYs

59
Q

Applied pharmacoeconomics is defined as

A

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

60
Q

helps practitioners justify the value of the products and services

A

applied pharmacoeconomics

61
Q

Dutch Guidelines for Pharmacoeconomic Research

A

designing, conducting and reporting pharmacoeconomic research

62
Q

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

A

societal

63
Q

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

A

the standard treatment

64
Q

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

A

Cost-utility analysis (CUA)

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

65
Q

(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.

A

CMA (cost minimization analysis)

66
Q

Why do we use the Manual for cost research?

A

promote the uniformity and the standardization of cost measurement and evaluation

67
Q

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

A

separately

68
Q

Guideline 7
The model used is preferred to be ___.

A

peer reviewed

69
Q

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

A

incremental effects and costs

70
Q

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

A

1 year
the first year

71
Q

Guideline 9
How are the costs and effects discounted?

A

data must be collected over a time period >1 Yr

start discounts after the first year

primary analysis = 4 % discount
onward = 1.5%

72
Q

Guideline 10
Sensitivity analysis

A
  • 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

73
Q

Guideline 11
Expert panel

A

pharmacoeconomic evaluation provided by the expert panel

74
Q

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

A

cost
drug therapy

75
Q

How is pharmacoec. relevant to socioeconomics?

A

it relates patients, society and economy, to drug therapy

76
Q

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

A

False
majority are vague and general

no consensus among the developers

77
Q

Overall recommendation from the authors of the pharmacoeconomics PDF

A
  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