week 5 economic evaluation Flashcards
What is economics?
study of unlimited needs/wants constrained by a limited number of resources (scarity)
Does decisions/choices need to be made for economics?
- YES!
- with each choice there is an “opportunity cost”
What is an “opportunity cost”?
it is when a choice is made and something else has to be given up
Do opportunity costs happen with health tech? why?
YES!
- b/c we can not pay for all
What 2 things do we look at to make a decision about what HT to use and to get rid of?
- Cost
- Benefits
What consists of “costs”?
- cost of HT
- cost of health care resources
- productivity loss
What examples are there for benefits?
- makes me feel better
- makes HT use more efficient
- makes some other things better
What 3 scenarios make an HT “economically attractive” when compared to another?
- cost LESS but does the same as other
- costs the same, but does BETTER
- cost LESS, does BETTER
What are 2 scenarios on the CE plane that you would need to consider cost effectiveness when choosing if new HT or old HT is better?
- low cost, low clinical effects
- high cost, high clinical effects
What are 2 key features of economic evaluations?
- cost
- clinical/health effects
What are two types of economic evaluations in HTAs?
- cost-utility analysis
- cost-effectiveness analysis
what is cost effectiveness analysis?
- uses the “incremental cost-effectiveness ratio” (ICER)
- net cost/changes in health outcome
- cost = dollars
- benefits = SINGLE dimension of effectiveness (lives saved, healthy days gained, heart attacks avoided)
If net costs are negative, what does that mean?
SAVE money
if net costs are positive, what does that mean?
COSTS money
What is “cost utility analysis”?
uses “ICUR”
instead of using single dimension effects, you use QALYs
net cost/changes in health outcome (IN QUALYs!!)
What is a QALY?
Quality Adjusted Life Years
- outcome measure that incorporates both QUANTITY of life(mortality-how long a person lives) and health-related QUALITY of life (morbidity)
- one QUALY = one year of perfect health
- death = zero
Why does cost-utility analysis use QUALY?
- more fair
- easier to compare across people
What is more prefered for economic evaluations of health tech ICUR or ICER?
ICUR!!
How do we determine what represents good value for money in Canada?
- there is no threshold
- there is a range of incremental cost per QUALY values
ex: range of $20000 to $100000 QUALY
What are the 14 guidelines for assessment?
- decision problem
- type of evaluation
- target population
- comparators
- Perspective of Analysis
- time horizon
- discounting
- modelling
- effectiveness
- measurement and evaluation of health
- resource use and costs
- analysis
- Equity
- uncertainity
- reporting
What is “decision making” problem include?
- specifying the interventions being compared
- the setting
- perspective of analysis
- costs and outcomes
- time horizon
- target population
What is the most comprehensive perspective to have in a perspective analysis?
societal perspective
What is a health care perspective?
means all costs and outcomes related to health care sector are included in the analysis
What should perspective of the reference case be?
of the publicly funded health care payer
