This document discusses key concepts in pharmacoeconomics and health economics. It explains that health economists evaluate health programs and treatments to determine their costs and benefits, including outcomes like quality-adjusted life years gained and incremental cost-effectiveness ratios. Health economists aim to maximize health benefits for populations within limited healthcare budgets. Their analyses can inform decisions around appropriate levels of healthcare spending and which interventions provide good value for money.
Arthritis herbal medicine background research- prevalence, life stages, causes, current medicines, constraints, nutrition, herbal medicines today, their limitations, options possible etc.
Ομιλία - Παρουσίαση: Ricardo Baptista Leite, Member of Parliament, Head of Public Health, Catholic University of Portugal
Τίτλος παρουσίασης: "Time Trends in Health for the Next Decade"
این کارگاه در تاریخ 13 آذرماه 1397 توسط دکتر امیرحسین حاجیمیری برگزار شد. در این کارگاه مفاهیم اولیه تعریف بازار، تفاوت بازار سلامت با سایر بازارها، مفاهیم Qaly و بالانس بازار و همچنین نحوه سنجش بازار برای کسبوکارهای حوزه سلامت توضیح داده شد.
Arthritis herbal medicine background research- prevalence, life stages, causes, current medicines, constraints, nutrition, herbal medicines today, their limitations, options possible etc.
Ομιλία - Παρουσίαση: Ricardo Baptista Leite, Member of Parliament, Head of Public Health, Catholic University of Portugal
Τίτλος παρουσίασης: "Time Trends in Health for the Next Decade"
این کارگاه در تاریخ 13 آذرماه 1397 توسط دکتر امیرحسین حاجیمیری برگزار شد. در این کارگاه مفاهیم اولیه تعریف بازار، تفاوت بازار سلامت با سایر بازارها، مفاهیم Qaly و بالانس بازار و همچنین نحوه سنجش بازار برای کسبوکارهای حوزه سلامت توضیح داده شد.
Clearly identifies the root cause of skyrocketing health cost and what companies and employees can do to reduce cost of health care.
You will learn proven strategies used successfully to reduce company health cost for over 20 years.
What is the Evidence and Return on Investment (ROI) of Obesity Prevention and...ICF
Originally presented at George Washington University's and ICF International's Research and Evaluation Forum (#GWICF2015), Dr. Ron Goetzel demonstrates why employers should look at value on investment (VOI) rather than return on investment (ROI) of workplace health promotion. Dr. Goetzel goes through:
• The severity and cost of obesity
• Why the workplace is the optimal environment for health programs
• Evidence and examples of how workplace health programs can bring VOI
• How employers can get VOI
To watch the video of Dr. Goetzel presenting these slides at the GW/ICF Research and Evaluation Forum, visit: http://www.icfi.com/ObesityPreventionRonGoetzel
A presentation for undergrad students visited Wolrd Health Organization (WHO) to understand what universal health coverage (UHC) is and how WHO works for UHC.
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Health co morbidity effects on injury compensation claims in NZ, and evidence...John Wren
This PPT presents the results of a suite of research undertaken to explore the evidence for health comorbidity effects on the cost of injury compensation claims, and what might be done about them. Comorbidity effects were shown to add approximately 10% extra to the cost of claims. There is good evidence that workplace health and wellness programmes are effective if well designed
The Hidden Risk That Is Tearing Your Company Apart Acbg 3 30 10leanhealthguru
The ACBG Edge is an process that allows construction companies manage the health and productivity risk of their employees. This complements American Construction Benefits Group\’s Lean Health Insurance Advantage. Together, these construction wellness processes create champion companies in 3 short years.
Prof David Hunter - Meeting the Challenge - Does the new NHS promote or hinde...Cumbria Partnership
'Meeting the Challenge of Long Term Conditions: Does the new NHS promote or hinder cooperation and integration?' - Professor David Hunter (Professor of Health Policy and Management at Durham University) from the Cumbria Neuroscience Conference
Graham was invited to the weekly seminar series by the Royal Brompton Hospital to deliver a presentation on health economics pertinent to Respiratory medicine. They care for a large number of patients with complex lung diseases at the institution and juggle the varied issues of resource (human, structural or financial). As one of many examples, high cost drugs for treating relatively unusual conditions comes up for debate all too frequently. The audience included consultant physicians, senior and junior trainees, nurses and other allied health professionals.
Date: 7 March 2019
Location: The Royal Brompton, London, UK
ABSTRACT
Objective: Stroke is one of the leading causes of death and disabilities worldwide. Cost-effectiveness analysis helps identify neglected opportunities
by highlighting interventions that are relatively inexpensive, yet have the potential to reduce the disease burden substantially. In India, there are
wide social and economic disparities. Socioeconomic environment influences occupation, lifestyle, and nutrition of social classes which in turn would
influence the prevalence and profile of stroke. By reduction of delays in access to hospital and improving provision of affordable treatments can
reduce morbidity and mortality in patients with stroke in India. This study is designed to measure and compare the costs (resources consumed) and
consequences (clinical, economic, and humanistic) of pharmaceutical products and services and their impact on individuals, healthcare systems and
society.
Methods: The purpose of this study is to analyze and conduct a cost-effectiveness analysis for the treatment of stroke in Guntur City Hospitals.
The patients were treated either with aspirin or clopidogrel. The health outcomes were measured using Modified Rankin Scale, A prominent risk
assessment scale for stroke. The pharmacoeconomic data were computed from the patient data collection forms.
Result: The incremental cost-effectiveness ratio of aspirin and clopidogrel were calculated to be Rs. 8046.2/year.
Conclusion: The study concludes that aspirin has the increased socioeconomic impact when compared to Clopidogrel and we can see that the earlier
therapy has supported discharge, home-based rehabilitation along with reduced hospital stay and hence preferable.
Keywords: Stroke, Pharmacoeconomics, Cost-effectiveness analysis, Aspirin, Clopidogrel, Incremental cost-effectiveness ratio.
We don’t have a functional competitive market in health care in the U.S. Consequently, many of the attributes of competitive markets that are beneficial in our lives are not present in health care. One significant negative externality of a dysfunctional market is an inability to discern quality. Consumerism is critical. Includes data and analysis from the 5TH ANNUAL HEALTHGRADES PATIENT SAFETY IN AMERICAN HOSPITALS STUDY – APRIL 2008
Essentials of investment including:
self-investment and financial investment
How to prepare our self for being a future leader of pharmacy
How to be an added value to make an impact
Presentation Skills as a crucial soft skill for Medical StudentsAmirhossein Hajimiri
Presentation skills workshop held in Students' research center in Tehran university of Medical sciences as a part of Samsonite series to empower medical students in soft skills to improve their chance for a better future.
IPhSA (Iranian Pharmacy Student Association) was the host.
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Clearly identifies the root cause of skyrocketing health cost and what companies and employees can do to reduce cost of health care.
You will learn proven strategies used successfully to reduce company health cost for over 20 years.
What is the Evidence and Return on Investment (ROI) of Obesity Prevention and...ICF
Originally presented at George Washington University's and ICF International's Research and Evaluation Forum (#GWICF2015), Dr. Ron Goetzel demonstrates why employers should look at value on investment (VOI) rather than return on investment (ROI) of workplace health promotion. Dr. Goetzel goes through:
• The severity and cost of obesity
• Why the workplace is the optimal environment for health programs
• Evidence and examples of how workplace health programs can bring VOI
• How employers can get VOI
To watch the video of Dr. Goetzel presenting these slides at the GW/ICF Research and Evaluation Forum, visit: http://www.icfi.com/ObesityPreventionRonGoetzel
A presentation for undergrad students visited Wolrd Health Organization (WHO) to understand what universal health coverage (UHC) is and how WHO works for UHC.
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Health co morbidity effects on injury compensation claims in NZ, and evidence...John Wren
This PPT presents the results of a suite of research undertaken to explore the evidence for health comorbidity effects on the cost of injury compensation claims, and what might be done about them. Comorbidity effects were shown to add approximately 10% extra to the cost of claims. There is good evidence that workplace health and wellness programmes are effective if well designed
The Hidden Risk That Is Tearing Your Company Apart Acbg 3 30 10leanhealthguru
The ACBG Edge is an process that allows construction companies manage the health and productivity risk of their employees. This complements American Construction Benefits Group\’s Lean Health Insurance Advantage. Together, these construction wellness processes create champion companies in 3 short years.
Prof David Hunter - Meeting the Challenge - Does the new NHS promote or hinde...Cumbria Partnership
'Meeting the Challenge of Long Term Conditions: Does the new NHS promote or hinder cooperation and integration?' - Professor David Hunter (Professor of Health Policy and Management at Durham University) from the Cumbria Neuroscience Conference
Graham was invited to the weekly seminar series by the Royal Brompton Hospital to deliver a presentation on health economics pertinent to Respiratory medicine. They care for a large number of patients with complex lung diseases at the institution and juggle the varied issues of resource (human, structural or financial). As one of many examples, high cost drugs for treating relatively unusual conditions comes up for debate all too frequently. The audience included consultant physicians, senior and junior trainees, nurses and other allied health professionals.
Date: 7 March 2019
Location: The Royal Brompton, London, UK
ABSTRACT
Objective: Stroke is one of the leading causes of death and disabilities worldwide. Cost-effectiveness analysis helps identify neglected opportunities
by highlighting interventions that are relatively inexpensive, yet have the potential to reduce the disease burden substantially. In India, there are
wide social and economic disparities. Socioeconomic environment influences occupation, lifestyle, and nutrition of social classes which in turn would
influence the prevalence and profile of stroke. By reduction of delays in access to hospital and improving provision of affordable treatments can
reduce morbidity and mortality in patients with stroke in India. This study is designed to measure and compare the costs (resources consumed) and
consequences (clinical, economic, and humanistic) of pharmaceutical products and services and their impact on individuals, healthcare systems and
society.
Methods: The purpose of this study is to analyze and conduct a cost-effectiveness analysis for the treatment of stroke in Guntur City Hospitals.
The patients were treated either with aspirin or clopidogrel. The health outcomes were measured using Modified Rankin Scale, A prominent risk
assessment scale for stroke. The pharmacoeconomic data were computed from the patient data collection forms.
Result: The incremental cost-effectiveness ratio of aspirin and clopidogrel were calculated to be Rs. 8046.2/year.
Conclusion: The study concludes that aspirin has the increased socioeconomic impact when compared to Clopidogrel and we can see that the earlier
therapy has supported discharge, home-based rehabilitation along with reduced hospital stay and hence preferable.
Keywords: Stroke, Pharmacoeconomics, Cost-effectiveness analysis, Aspirin, Clopidogrel, Incremental cost-effectiveness ratio.
We don’t have a functional competitive market in health care in the U.S. Consequently, many of the attributes of competitive markets that are beneficial in our lives are not present in health care. One significant negative externality of a dysfunctional market is an inability to discern quality. Consumerism is critical. Includes data and analysis from the 5TH ANNUAL HEALTHGRADES PATIENT SAFETY IN AMERICAN HOSPITALS STUDY – APRIL 2008
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self-investment and financial investment
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
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This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
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The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
7. Reduction of Tobacco Use
Programs in School
Banners and
Advertisement
TV Programs
Medicines
Campaigns
…
Total Number of
Smokers
Reduced incidence
Reduction in cancers
Amount of cigarettes
Rate of COPD
…
Initiatives Outcomes
8. How do we Decide?!
How much to invest in Health?
15. A high level of human health promotion shall be
ensured in all policies and activities.
WHO Health Promotion Milestones
Health is a state of complete physical,
mental and social well-being.
WHO Constitution
18. Perspective of the Studies
Perspective is an economic term that describes whose costs are
relevant based on the purpose of the study
• Institutional
• Third party
• Patient(out of-pocket expenses, such as copayments, deductibles, lost wages, and transportation costs)
• Governmental
• Societal (costs to the insurance company, patient, other sector costs, and indirect costs because of the loss of productivity)
19. • How much money for one year of perfect health?
• 1500 EU citizens: 40,000 €
• 1002 Iranian (Tehran) : ~ 1000-2650 $ (0.22–0.56 of Iran’s
GDP/capita)
References:
Expert Review of Pharmacoeconomics & Outcomes Research, Volume 8, 6 (2008)
Cost Effectiveness and Resource Allocation, volume 17, 4 (2019)
20. QALY
A year of life lived in perfect health is worth 1 QALY (1 year of life × 1 Utility value).
21. Example Breast Cancer
Disease State Utility Level
Recurrence Free 0.78
Local Recurrence 0.78
Distant Recurrence (DR) 0.69
DR with Metastasis 0.60
Hall et al, Journal of the National Cancer Institute, 2012
22. How to Measure the “Utility Level”
• Direct
• VAS: Visual Analogue Scale
• SG: Standard Gamble
• TTO: Time Trade Off
• Indirect
• Generic: EuroQoL5D, SF36
• Disease Specific
29. Where is the Threshold?
• Benchmarking
• WHO
Highly Cost-effective < 1 GDP per Capita
Cost-effective 1 GDP per Capita < ICER < 3 GDP per Capita
Not Cost-effective > 3 GDP per Capita
Reference: Bulletin of the World Health Organization 2015;93:118–124
30. Imagine a new TECHNOLOGY …
60,000 €
for a 2-year period of therapy
?
31.
32. But …
• Economic evaluation should be used alongside
other considerations in a transparent decision-
making process, rather than isolation based on a
single threshold value.
Reference: Bull World Health Organ. 2016 Dec 1;94(12):925-930.
35. Is a QALY a QALY?
• Which one do you prefer?
Nord E, The person-trade-off approach to valuing health care programs.
Med Decis Making. 1995 Jul-Sep;15(3):201-8
1
0
1.0
0.8
0.4
0.2
Same Life Exceptency
Same cost of drug
Same prevalence
36. 1967; Changes in the Costs of Treatment of Selected Illnesses
1994; The high cost of dying
37. Social Reference Point
Rationalising rationing: economic and other considerations in the debate about funding of Viagra
Stolk et. Al, Volume 59, Issue 1, Pages 53-63, Health Policy 2002
38. “We conclude that Viagra is very cost-effective”
GOOD ICER; NOT FUNDED
39. Another Side!
• Variable Thresholds in the Netherlands:
Condition Threshold (per QALY)
End of life Up to 100,000
Severe condition 80,000
Moderate burden 50,000
Mild burden 20,000
