Study Set Content:
results are expressed as: ratio of benefit to cost
cost-benefit analysis (CBA
net cost or benefit =
benefit-cost
allows uniform comparison of programs or interventions with entirely different outcomes
CBA
method to compare treatment alternatives or programs where costs are measured in monetary terms and outcomes is expressed in terms of patient preferences or quality of life
cost-utility analysis (CUA)
CUR =
cost / QALY
Applications of economic analysis • () in decision making and allocating scarce resources •() the value of a new agent • () decision making
assist, assessing, formulary
• drug policy decisions, treatment guidelines and justify the addition of()clinical service
• pricing in()industry
• decision on()
new , pharmaeutical , reimbursement
use such information to decide whether to pay for a particular treatment, or to determine what price they are willing to pay
– third-party payers
Guidelines for performing a pharmacoeconomic analysis
1. defining the ()
2. determining the study's () 3. determining the () and outcomes 4. selecting the appropriate () method5. placing () on the outcomes
problem, perspective, alternatives, pharmacoeconomic, monetary values
6. ()study resources
7. establishing the () of the outcomes
8. applying()
9. () costs or performing a sensitivity or incremental cost analysis
10. presenting the results, along with any() of the study
identifying , probabilities, decision analysis, discounting, limitations
uses available quantitative estimates to representalternative strategies in terms of the probabilities that certain events and outcomes will occur and the values of the outcomes that would result from each strategy.
Decision analysis
employed in health economic analysis• involves synthesizing evidence from sources that include RCTs, observational studies, case registries, public health statistics, preference surveys and insurance claim databases
Decision analysis
Decision models often are shown in the form of "decision trees" with branching steps and outcomes with their associated probabilities and values.
Decision analysis
• to () the distribution of outcomes for patient populations and associated costs of care
• used as a tool to () development of clinical practice guidelines for specific health problems
predict, support
• to ()the likelihood of potential outcomes of alternative clinical strategies (such as a decision to undergo a screening test or to select among alternative therapies) or to identify the clinical strategy that has the greatest preference for a patient
• used to set ()for HTA
relate , priorities
Steps in Decision Analysis1. Develop a () (e.g., a decision tree) that depicts the set of important choices (or decisions) and potential outcomes of these choices. For treatment choices, the outcomes may be health outcomes (health states); for diagnostic choices, the outcomes may be test results (e.g., positive or negative).
model
2. Assign estimates (based on available literature) of the probabilities (or magnitudes) of each potential () given its antecedent choices.
outcome
3. Assign estimates of the value of each outcome to reflect its ()
utility or desirability
is an individual's satisfaction or happiness with domains of life insofar as they affect or are affected by health.
Health-related quality of life (HRQL)
is a measurement that combines the quality and length of life.
quality-adjusted life year (QALY)
