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HSS4108 > week 5 economic evaluation > Flashcards

week 5 economic evaluation Flashcards

1
Q

What is economics?

A

study of unlimited needs/wants constrained by a limited number of resources (scarity)

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2
Q

Does decisions/choices need to be made for economics?

A
  • YES!
  • with each choice there is an “opportunity cost”
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3
Q

What is an “opportunity cost”?

A

it is when a choice is made and something else has to be given up

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4
Q

Do opportunity costs happen with health tech? why?

A

YES!
- b/c we can not pay for all

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5
Q

What 2 things do we look at to make a decision about what HT to use and to get rid of?

A
  1. Cost
  2. Benefits
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6
Q

What consists of “costs”?

A
  • cost of HT
  • cost of health care resources
  • productivity loss
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7
Q

What examples are there for benefits?

A
  • makes me feel better
  • makes HT use more efficient
  • makes some other things better
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8
Q

What 3 scenarios make an HT “economically attractive” when compared to another?

A
  1. cost LESS but does the same as other
  2. costs the same, but does BETTER
  3. cost LESS, does BETTER
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9
Q

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?

A
  1. low cost, low clinical effects
  2. high cost, high clinical effects
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10
Q

What are 2 key features of economic evaluations?

A
  1. cost
  2. clinical/health effects
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11
Q

What are two types of economic evaluations in HTAs?

A
  1. cost-utility analysis
  2. cost-effectiveness analysis
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12
Q

what is cost effectiveness analysis?

A
  • 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)
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13
Q

If net costs are negative, what does that mean?

A

SAVE money

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14
Q

if net costs are positive, what does that mean?

A

COSTS money

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15
Q

What is “cost utility analysis”?

A

uses “ICUR”

instead of using single dimension effects, you use QALYs

net cost/changes in health outcome (IN QUALYs!!)

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16
Q

What is a QALY?

A

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
17
Q

Why does cost-utility analysis use QUALY?

A
  • more fair
  • easier to compare across people
18
Q

What is more prefered for economic evaluations of health tech ICUR or ICER?

A

ICUR!!

19
Q

How do we determine what represents good value for money in Canada?

A
  • there is no threshold
  • there is a range of incremental cost per QUALY values

ex: range of $20000 to $100000 QUALY

20
Q

What are the 14 guidelines for assessment?

A
  1. decision problem
  2. type of evaluation
  3. target population
  4. comparators
  5. Perspective of Analysis
  6. time horizon
  7. discounting
  8. modelling
  9. effectiveness
  10. measurement and evaluation of health
  11. resource use and costs
  12. analysis
  13. Equity
  14. uncertainity
  15. reporting
21
Q

What is “decision making” problem include?

A
  • specifying the interventions being compared
  • the setting
  • perspective of analysis
  • costs and outcomes
  • time horizon
  • target population
22
Q

What is the most comprehensive perspective to have in a perspective analysis?

A

societal perspective

23
Q

What is a health care perspective?

A

means all costs and outcomes related to health care sector are included in the analysis

24
Q

What should perspective of the reference case be?

A

of the publicly funded health care payer

25
Q

What should the perspective of the economic evaluation be related to?

A

the decision problem

26
Q

What needs to be considered for the “time horizon”?

A
  • for reference case = long enough to capture ALL relevant differences in future costs and outcomes associated with interventions being compared
  • relate directly to the decision problem
  • based on condition and impact of intervention
27
Q

What is “discounting”?

A

calculating the present values of future costs and consequences

taking into account the impact of time on how those costs and outcomes are valued

to make sure you are talking of same costs and benefits

28
Q

What is with “discounting” in canada for the reference case?

A

cost and outcomes that occur beyond one year should be discounted to present values at a rate of 1.5% per year!

29
Q

In “measurement and Valuation of health”, what method should be used to capture the value of effect of an intervention for the reference case?

A

QUALY

30
Q

What needs to be reflected in the “health preferences” when conducting “measurement of valuation of health”?

A
  • health states in the model
  • the general canadian population
31
Q

Should researchers use indirect or direct method of measurement when obtaining health preferences for reference case?

A

indirect

32
Q

What should you do for the reference case in terms of “resource uses and costs”?

A
  • need to systematically identify, measure, value, and report all relevant resources based on the perspective of the publicly funded health care payer
33
Q

Should economic evaluations acknowledge and respect both horizontal and vertical equity?

A

YES!

34
Q

What is “methodological uncertainty”?

A

concerned with unresolved questions about methods

ex: the appropriate discount rate to apply to costs and outcomes

35
Q

What is “parameter uncertainity”?

A

concerned with the extent to which the estimated value reflects to TRUE value for each parameter in anaylsis

36
Q

What is “structural analysis”?

A

considers whether all the relevant aspects of the health condition and interventions are adequately captured by chosen model structure

37
Q
A

HSS4108 (11 decks)

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