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  • Pharmacoeconomics1

    1. 1. PHARMACOECONOMICS <ul><ul><li>Jinender Kumar </li></ul></ul>
    2. 2. <ul><li>Pharmacoeconomics Research </li></ul><ul><li>Uses of Pharmacoeconomics Research </li></ul><ul><li>Need for Pharmacoeconomics Research </li></ul><ul><li>Types of Pharmacoeconomics Research </li></ul><ul><li>Sensitivity Analysis </li></ul><ul><li>Discounting </li></ul><ul><li>Journals </li></ul><ul><li>References </li></ul>Preview
    3. 3. PHARMACOECONOMICS RESEARCH <ul><li>Sub-discipline of health economics </li></ul><ul><li>compares the costs (i.e resources consumed) and consequences (i.e economic, clinical and humanistic) of the drug therapies and medical interventions </li></ul><ul><li>PE analysis </li></ul><ul><ul><li>efficient allocation of limited resources among competing alternative medications and services </li></ul></ul>
    4. 4. VALUE Health Outcome Cost
    5. 5. USE OF PHARMACOECONOMIC RESEARCH <ul><li>Pharmaceutical reimbursement </li></ul><ul><li>Selecting formulary products </li></ul><ul><li>Price Negotiations </li></ul><ul><li>Clinical Practice Development guidelines </li></ul><ul><li>Communication to prescribing physicians </li></ul>
    6. 6. NEEDS TO MONITOR VALUE OF PHARMACEUTICALS <ul><li>Increased cost. </li></ul><ul><li>Increased number of alternatives available to treat illness and disease. </li></ul><ul><li>Growing demand for pharmaceuticals. </li></ul><ul><li>Introduction of high cost biotechnology products. </li></ul>
    7. 7. TYPES OF PHARMACOECONOMIC EVALUATION <ul><li>Cost-minimization analysis (CMA) </li></ul><ul><li>Cost-benefit analysis (CBA) </li></ul><ul><li>Cost-effectiveness analysis (CEA) </li></ul><ul><li>Cost-utility analysis (CUA) </li></ul><ul><li>Cost-consequence analysis (CCA) </li></ul>
    8. 8. COMPARING PHARMACOECONOMIC METHODOLOGIES <ul><li>METHODOLOGY </li></ul><ul><li>Cost-Minimization </li></ul><ul><li>Cost-Effectiveness </li></ul><ul><li>Cost-Benefit </li></ul><ul><li>Cost-Utility </li></ul><ul><li>Cost-Consequence </li></ul><ul><li>CONSEQUENCES </li></ul><ul><li>Natural Units </li></ul><ul><li>Natural Units </li></ul><ul><li>Dollars </li></ul><ul><li>Quality-Adjusted Life Years (QALYs) </li></ul><ul><li>Natural Units, Dollars or </li></ul><ul><li>QALYs </li></ul>
    9. 9. STEPS FOR CONDUCTING A PHARMACOECONOMIC EVALUATION <ul><li>Defining the problem and stating the objective. </li></ul><ul><li>Identifying the perspective and alternative interventions to be compared. </li></ul><ul><li>Identifying and measuring the outcomes of each alternative. </li></ul><ul><li>Identifying, measuring and valuing the costs of all alternatives. </li></ul>
    10. 10. DEFINE THE PROBLEM AND STATE THE OBJECTIVE <ul><li>All pharmacoeconomic evaluation should have a clear and concise statements of problem or question to be addressed. </li></ul><ul><li>e.g. What is the most cost-effective regimen for the treatment of type II diabetes? </li></ul>
    11. 11. PERSPECTIVE <ul><li>Point of view from which the study is taken </li></ul><ul><li>Determines what will be measured, what are the costs and benefits, and how they will be valued </li></ul><ul><li>Guides and limits application of study results </li></ul><ul><li>What are the possible perspectives in PE studies? </li></ul>
    12. 12. PERSPECTIVE <ul><li>Pharmacoeconomic evaluation can be conducted from several different perspectives including the employer, the patient, the health insurance plan, society, or the government. </li></ul>
    13. 13. IDENTIFYING ALTERNATIVE INTERVENTIONS <ul><li>Which alternative should be compared in pharmacoeconomic evaluation? </li></ul>
    14. 14. IDENTIFYING ALTERNATIVE INTERVENTIONS <ul><li>Alternatives should be compared only when one of the alternatives is either more costly or more effective. </li></ul>
    15. 15. IDENTIFY AND MEASURE OUTCOMES OF EACH ALTERNATIVE INTERVENTION <ul><li>Some of the outcomes of the treatment are: </li></ul><ul><li>A cure (health is restored) </li></ul><ul><li>Improved quality of life </li></ul><ul><li>Decreased incidence of morbidity </li></ul><ul><li>Extended life </li></ul><ul><li>Relief or reduction in symptoms </li></ul><ul><li>No effect </li></ul><ul><li>Increased morbidity </li></ul><ul><li>Mortality </li></ul>
    16. 16. OUTCOMES <ul><li>Both positive and negative outcomes should be addressed </li></ul><ul><li>Positive outcomes: drug’s efficacy measure </li></ul><ul><li>Negative outcomes: ADR and treatment failure </li></ul>
    17. 17. IDENTIFYING,MEASUREMENT AND VALUATION OF COSTS <ul><li>From the measurement aspect, two components are costs and consequences </li></ul><ul><li>Three important concepts related to costs are identifying, measuring, and placing a value on resources or costs. </li></ul>
    18. 18. IDENTIFYING RELEVANT COSTS <ul><li>What is cost? </li></ul><ul><li>How is cost different from price? </li></ul>
    19. 19. COSTS <ul><li>Direct costs : costs to deliver services to patient; both medical and non-medical </li></ul><ul><li>Indirect costs : cost of treatment to patient or society </li></ul><ul><li>Intangible costs : quality of life </li></ul>
    20. 20. Costs can be described in many ways <ul><li>Cost / unit (cost/tab, cost/vial) </li></ul><ul><li>Cost / treatment </li></ul><ul><li>Cost / person </li></ul><ul><li>Cost / person / year </li></ul><ul><li>Cost / case prevented </li></ul><ul><li>Cost / life saved </li></ul><ul><li>Cost / DALY (disability-adjusted life year) </li></ul>
    21. 21. MEASURING COSTS <ul><li>After cost identification the next step involves measuring the costs. </li></ul><ul><li>Measurement involves counts of resources consumed in units depending on the type of costs. </li></ul>
    22. 22. VALUING COSTS <ul><li>After cost measurement, the next step involves placing a dollar value on the resources. </li></ul>
    23. 23. SENSITIVITY ANALYSIS <ul><li>Test key outcome or cost assumption of an analysis to determine how sensitive the results are to variation or to uncertainty. </li></ul><ul><li>In pharmacoeconomic evaluations, the accuracy with which costs can be identified, measured, or valued will vary. </li></ul>
    24. 24. DISCOUNTING <ul><li>The purpose of discounting is to present all costs in their present value and to incorporate the society’s time preference for money. </li></ul><ul><li>Alternatives that have costs or benefits realized at different times should be discounted to a present value to make valid comparisons. </li></ul>
    25. 25. JOURNALS <ul><li>Value in Health </li></ul><ul><li>Pharmacoeconomics </li></ul><ul><li>Health Economics </li></ul><ul><li>Pharmacoeconomics and Outcomes News </li></ul><ul><li>Clinical Therapeutics - Pharmaceutical Economics & Health Policy </li></ul><ul><li>Health Affairs (The Policy journal) </li></ul>
    26. 26. REFERENCES <ul><li> </li></ul><ul><li>Bootman JL, Townsend RJ, Mcghan WF. Principles of Pharmacoeconomics. 3 rd edition. Harvey Books Company. 2005. </li></ul><ul><li>McCArthy Rl, Schafermeyer KW. Introduction to Health Care Delivery. 3 rd edition. Jones and Barlett Publisher. 2004. </li></ul><ul><li>Bonk RJ. Pharmacoeconomics in Perspective:a primer on reseach, techniques and perspective. Pharmaceutical product press. 1999. </li></ul><ul><li>Rychlik R.Strategies and Pharmacoeconomics and Outcomes Research. Pharmaceutical Heritage Edition. 2003. </li></ul><ul><li>Vogenberg FR. Introduction to Applied Pharmacoeconomics. Mcgraw-Hill Publications. 2001. </li></ul>
    27. 27. ASSIGNMENT <ul><li>Prepare a short report on each type of pharmacoeconomics analysis. </li></ul><ul><ul><li>How each type of PE analysis is defined? </li></ul></ul><ul><ul><li>What perspectives can be taken in each type of PE analysis ? </li></ul></ul><ul><ul><li>How CER, CBR, and CUR are defined? </li></ul></ul><ul><ul><li>How ICER, ICBR, and ICUR are defined? </li></ul></ul><ul><ul><li>What type of data can be used to conduct PE analysis ? </li></ul></ul><ul><ul><li>What are different study designs to conduct PE analysis? </li></ul></ul><ul><ul><li>Examples of each type of PE analysis. </li></ul></ul>