Quality of life and health economics Flashcards

1
Q

who are in charge of deciding which drugs are approved for use in the UK

A

NICE

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2
Q

NICE uses

A

HTA

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3
Q

HTA

A

health technology assessments

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4
Q

HTA use

A

cost effective analysis

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5
Q

CEA is concerned with

A

ratio of cost to health effect

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6
Q

CEA is the comparative

A

analysis of alternative course of actions terms cost and consequence for health

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7
Q

CEA looks at

A

treatment A and B and compares their cost and health outcomes

e.g. if Drug A is cheaper and more effective than Drug B then Drug A is the better value

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8
Q

health technology assessment is interested

A

accumulation of QALYs over time

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9
Q

QALY

A

is measure of overall effectiveness in terms of life and quality of life (0-1)

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10
Q

QALYs =

A

life expectancy (life years) x HR-Qol (utility)

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11
Q

2 years in full quality of life would mean

A

2 QALYs

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12
Q

2 years in 50% quality of life

A

2x 0.5= 1

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13
Q

quality of life is measured between

A

0-1

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14
Q

the more QALYs

A

the better

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15
Q

QALY is a generic measure of

A

disease burden- including both the quality of life lived and quanitity

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16
Q

how are QALYs used

A

used in economic evaluation to assess the value for money of medical interventions

17
Q

1 QALY equates to

A

one year of perfect health

18
Q

3 different methods of calculating HR-QoL

A
  • EQ:5D
  • TTO
  • standard gamble
  • visual analogues
19
Q

on a graph of HR-QoL and time..

A

the area under the graph is the number of QALYs gained

20
Q

EQ:5D

A

a questionnaire used to measure HR-QoL

21
Q

what are the 5 EQ:5D

A

1) mobility
2) self-care
3) depression and anxiety
4) usual activities
5) pain/discomfort

22
Q

these 5 EQ:5D are rated out of

A

3, then these are ordered into a 5 digit number e.g. 1,2,1,3,1 and a computer calculates score

23
Q

NICE prefers

A

EQ:5D as a measure of HR-QoL

24
Q

standard gamble

A

(think of drawings)
the worst the health state, the higher the risk of immediate death one will accept in order to avoid it

  • involves weighing trade-offs
  • measures the preference of individuals under risk situations
25
why is standard gamble sometimes preferred
since in real life, patient swill need to make risky decisions
26
visual analogues
another way of measuring HR-QoL - gives you a scale and asks how you feel on that day regarding your disease - simple and quick
27
Time trade offs
(think of drawing) basically say how much shorter would you cut your life to be living in full health again, at least for a while. -evaluates the desirability of living the remainder of ones life in the current state of health or shorter life in excellent heath
28
what is used to measure cost-effectiveness ratio
ICER
29
ICER stands for
incremental cost effectiveness ratio
30
ICER involves calculated
QALYs
31
equation for ICER
difference in cost/ difference in QALYs
32
ICER- cost and QALYs
costs and QALYs of the CURRENT technology are always subtracted form the new technology
33
what is the current treatment always subtracted from the new technology
expected that health gain will be achieved with the new technology
34
when thinking about strategies we must think of
hospital care cost - emergency treatment cost - end of life palliation
35
models must include
long term consequential costs as well as obvious up front costs of buying the treatment
36
If patient succumbs to the disease
NHS cost is zero
37
what is the threshold of £/ QALY gained
£20,000
38
however up to £ / QALY gained e.g. at end of life
£30,000