Pharmacoeconomics Exam 1 Study Guide
Costs in Pharmacoeconomic Analyses . Health economics: applies theories, tools, and concepts of economics to health and health care outcomes o Assessment of most e cient use of available resources Three outcome categories o Clinical (death, disease) Economic (dollars) Humanis c (disability, discomfort, dissa sfac on) Ex. QOL, PROs Clinical outcomes o Intermediary Ex. A1c, BP, cholesterol/TG o Pa ent-oriented outcomes - Experienced by the pa ent :Ex. CV disease, morbidity/mortality Compare healthcare expenditures in the US with other industrialized countries o US spends trillions of dollars in health expenditures annually Signi cantly more than other countries Drivers of higher healthcare costs in US : Inpa ent & outpa ent care Higher payments to hospitals & physicians Hospital procedures are more expensive in US Rx drugs -Higher cost in US Health administra on 4x more/person in US 5fi% from private health insurance costs o Universal healthcare in other countries o US has low healthcare e ciency in increasing life expectancy compared to dollars spent List healthcare resources that contribute to costs o Commonly used resources: : Medica ons : Diagnos c tes ng : Hospital stays Physician visits, consults : Surgical procedures Other resources (personnel, equipment, supplies) Describe types of costs & the di erence between costs & charges o Healthcare costs -- expenses incurred, or resources consumed, in provision of healthcare : Component of healthcare outcomes Cost of healthcare Hospital care Professional services Rx drugs o fi factors driving growth in spending Newly marketed drugs
Price changes of exisng agents Increases in u liza on Nursing care facili es Home health care Nursing homes Medical products Govt. admin Insurance costs Public health ac vi es Investment
: Charge = cost + pro t Vary depending on payer or may be set by regula on or contract : Charged amt may not = reimbursed amount : Can use ra o of cost-to-charge (RcC) to es mate costs from charges Describe the types & components of a PE evalua on o Types of PE evalua on : Cost minimiza on analysis Cost bene t analysis Cost e ec ve analysis Cost u lity analysis o Components of PE evalua on :Evaluates inputs (costs) Direct medical costs - cost of services/products assoc. directly with a medical condi on/interven on Direct non-medical costs -- cost of providing non-medical assistance because of medical condi on/interven on Indirect costs -- cost of lost/reduced produc vity resulng from morbidity/premature mortality due to medical condi on/interven on Intangible costs -- costs assigned to amount of su ering that occurs bc of disease/interven on Fixed vs variable costs Evaluates consequences Analy cal perspec ve: impacts what costs/consequences you are interested in Iden fy sources of iden fying drug & healthcare costs o External sources : Published literature/studies : External databases Websites -- consumer cash pricing Internal sources : Payer - Hospital, community pharmacy, or other site where eval is occurring Drug pricing Average wholesale price (AWP) Wholesale acquision cost (WAC) : Federal