PHRM3031 Pharmacoeconomics Flashcards
scarcity
health resources are finite
opportunity cost
maximum benefit that could have been obtained with alternative use of resources
Health Technology Assessment (HTA)
definition
examples
key questions (3)
effective assessment
-range of processes and mechanisms that use scientific evidence to asses the quality, safety, efficacy, effectiveness and cost effectiveness of health services
-pharmaceuticals, diagnostic tests, medical devices, prostheses, medical procedures and public health interventions
key questions:
-is it safe?
-does it improve health outcomes?
-is it cost effective?
effective assessment involves:
-evaluating the comparative harms and benefits
-understanding the cause, origin and prevalence of disease and knowledge of best practice treatment pathways
pharmacoeconomics
definition
the assessment of the costs of clinical outcomes associated with alternative drug treatments
- compares the costs and benefits of a new and an existing pharmaceutical product –> is it cost effective
- used to inform a decision for optimal healthcare resource allocation
economic evaluation
how?
comparative analysis of alternative medicines in terms of costs and consequences (=benefits = outcomes)
–> identify, measure, value and compare costs and consequences of alternatives
cost -types
direct
directly associated with the intervention (formal sector)
i) direct health care costs (medicines, salaries etc
(ii) direct non-health care costs (transport to and from)
cost -types
indirect
generated in non-healthcare sectors so include costs to the rest of economy (productivity gains and losses as a result of process and outcomes of health care)
cost-types
intangible
social and psychic costs associated with treatment (anxiety, fear and discomfort) –> very difficult to value
cost benefit analysis
- broadest form of economic evaluation
- both cost and benefits are expressed in $
- -> outcome may be expressed as:
- -ratio (cost benefit ratio_
- -net value (outcome minus cost)
- -if B/C >1, that alternative is socially valuable
- costs and benefits of differing programs - compared because expressed in the same units
- generally not used in pharmacoeconmics (very difficult to assign monetary value to health outcomes)
cost minimisation analysis
- compares costs in $ of alternative therapies
- -considered to have identical effects
- -assumes outcomes of intervention are the same
- results are expressed as net cost (savings)
- aim of analysis is to determine which Tx costs less
- common example: use of generic vs brand pharmaceuticals
cost effectiveness analysis
- compares cost in $ between alternative programs to achieve a clinical outcome
- outcomes can be defined in terms of:
- -life years saved, injuries prevented etc
- -measured in natural units
- assumes that alternative programs have same goal
- can only compare intervention with same outcome measure
cost utility analysis
- measuring improvement in health - on a scale measure both length and quality of life
- -> quality adjusted life year (QALY)
- preferences for health states are measured –> utility weight (or health utility) x length of life = QALY
- utility weights –> HRQoL of the health state under consideration (often use disability-adjusted life years [DALY] esp. in developing countries
what is HRQoL?
QoL is general wellbeing
Health Related QoL is wellbeing as it relates to your health
multiple domains: physical, functioning, psychological, social/occupational
QoL is assessed by the patient
factors influencing QoL
- intervention/treatment
- disease/processes
- labelling: diagnosis brings on ‘change’
- concomitant care
- non-related life events
health utilities
utilities represent the strength of an individual’s preferences for specific health-related outcomes
two main steps:
1.defining a set of health states
2.valuing health states (preferences) a.direct and b.indirect
