Quality of life and health economics

Question 1

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

Answer 1

NICE

Question 2

NICE uses

Answer 2

HTA

Question 3

HTA

Answer 3

health technology assessments

Question 4

HTA use

Answer 4

cost effective analysis

Question 5

CEA is concerned with

Answer 5

ratio of cost to health effect

Question 6

CEA is the comparative

Answer 6

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

Question 7

CEA looks at

Answer 7

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

Question 8

health technology assessment is interested

Answer 8

accumulation of QALYs over time

Question 9

QALY

Answer 9

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

Question 10

QALYs =

Answer 10

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

Question 11

2 years in full quality of life would mean

Answer 11

2 QALYs

Question 12

2 years in 50% quality of life

Answer 12

2x 0.5= 1

Question 13

quality of life is measured between

Answer 13

0-1

Question 14

the more QALYs

Answer 14

the better

Question 15

QALY is a generic measure of

Answer 15

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

Question 16

how are QALYs used

Answer 16

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

Question 17

1 QALY equates to

Answer 17

one year of perfect health

Question 18

3 different methods of calculating HR-QoL

Answer 18

• EQ:5D
• TTO
• standard gamble
• visual analogues

Question 19

on a graph of HR-QoL and time..

Answer 19

the area under the graph is the number of QALYs gained

Question 20

EQ:5D

Answer 20

a questionnaire used to measure HR-QoL

Question 21

what are the 5 EQ:5D

Answer 21

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

Question 22

these 5 EQ:5D are rated out of

Answer 22

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

Question 23

NICE prefers

Answer 23

EQ:5D as a measure of HR-QoL

Question 24

standard gamble

Answer 24

(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

Question 25

why is standard gamble sometimes preferred

Answer 25

since in real life, patient swill need to make risky decisions

Question 26

visual analogues

Answer 26

another way of measuring HR-QoL

• gives you a scale and asks how you feel on that day regarding your disease
• simple and quick

Question 27

Time trade offs

Answer 27

(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

Question 28

what is used to measure cost-effectiveness ratio

Answer 28

ICER

Question 29

ICER stands for

Answer 29

incremental cost effectiveness ratio

Question 30

ICER involves calculated

Answer 30

QALYs

Question 31

equation for ICER

Answer 31

difference in cost/ difference in QALYs

Question 32

ICER- cost and QALYs

Answer 32

costs and QALYs of the CURRENT technology are always subtracted form the new technology

Question 33

what is the current treatment always subtracted from the new technology

Answer 33

expected that health gain will be achieved with the new technology

Question 34

when thinking about strategies we must think of

Answer 34

hospital care cost

• emergency treatment cost
• end of life palliation

Question 35

models must include

Answer 35

long term consequential costs as well as obvious up front costs of buying the treatment

Question 36

If patient succumbs to the disease

Answer 36

NHS cost is zero

Question 37

what is the threshold of £/ QALY gained

Answer 37

£20,000

Question 38

however up to £ / QALY gained e.g. at end of life

Answer 38

£30,000