Pharmaeconomics Flashcards
What is pharma economics and what is it used to consider?
Comparing the costs and benefits of interventions and making choices is the basis of it.decision makers need to consider the cost and the benefit of the new interventions – in uk cost effectiveness is preffered Interventions are compared with one another or the SOC and an incremental cost for the benefit is reported. Soc=standard of care.
What is EQ-5D and what does it consider?
its a questionnaire,includes mobility,self- care,effect(improvement and worsening) on activities,pain/discomfort experienced,anxiety/depression.The EQ-5D can be used to calculate utility and compare between therapies.The eq-5d does not include social contact or
employment and certain disease influence EQ-5D- more physical conditions may
influence it more than mental conditions
What is QALY?
A quality adjusted life year,one qaly = 1 year of life in perfect health.
What is the icer formulae
cost a-cost b/benefit a- benefit b
If a drug falls in quadrant 2 it is
less effective and more expensive,so will be
rejected.if a drug falls into quadrant 4 it is more effective and less expensive so will be accepted- if drug falls into quadrant 1 or 3 an icer must be performed to compare the cosy effectiveness.
A drug is determined cost effective if it is….
20-30,000 icer per qaly, end of life
treatment(extends life beyond 3 months)is cost effective if 50,000 icer ber qaly
What are decision analysis models?
Are used to simulate costs and consequences of different care pathways.The probability of a patient following a pathway is assessed and the pathway costs and benefits are assigned,decision trees may be used for simple diseases in acute setting,but for complex diseases there are too many options for them to be viable.
What is the markov model?
The probability of length of time spent in different health states is calculated,developing QALY based on the cycling.This gives better indication on cost effective scale.Its useful for cancer as it accounts for progression states.
What are the 3 elements of the markov model?
Disease free- death- progression
What is sensitivity analysis?
the study of how changes in the model inputs –
(quantities,price,life years,probabilities)affects the model outputs (average or expected costs,average or expected benefits,average or expected ICERs or net monetary benefit.
What are the 2 types of sensitivity anaylsis?
Deterministic- Values for one or more parameters are chosen and the rest are kept constant.
Probabilitsitic- parameters and probability distribution are assigned and stimualtions are used to compare new icers.
Evaluating the costs of breast cancer meds -to gain authorisation it must?
in order to gain authorisination it can be very costly so for companies to make some of that money back,most cancers are treated with approved agents(dequentially or in combo), this creates a virtual monopoly.Because the use of one drug does not automatically mean that the others are no longer needed.Gernerics are seen as substandard to new therapies and therefore they are not used.Cancer is seen as a dangerous disease so there is increased willingness to pay a higher price for treatment.
What is the CDF
The cancer drug fund – established in 2010, its aim was to give cancer patiets access to non nice approved drugs.aianitslly it was set at 50 million, the fund is now 280 million.it was put in place temporarily as a new method of cost effectiveness analyss – this was developed through VBP – Value bases pricing.In terms of pharmacoeconomics the cancer drugs fund is disasterous, there has been an exponential rise in the cost .The CDF may actually undermine the underlying NHS and NICE principle that all lives are of equal value.The new cdf from 2016- is part of nice and aims to review all new cancer drugs within 90 days of license of use in England and 1 of the following decisions are made.
What 3 decisions will be made regarding their use?
Yes- the drug should be used routinely in the nhs,no- the drug should not be available routinely, maybe- the drug can be made available via cancer drugs fund – to ensure efficacy before allowing routine availability.
