Pharmacoeconomics Exam 1 Study Guide
Costs in Pharmacoeconomic Analyses Compare healthcare expenditures in the US with other industrialized countries US spends trillions of dollars in health expenditures annually o 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 :53% 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 ctes ng - Hospital stays Physician visits, consults Surgical procedures Other resources (personnel, equipment, suppliesffi Describe types of costs & the di erence between costs & charges 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 3 factors driving growth in spending : Newly marketed drugs : Price changes of exis ng 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 o Charges -- amount a provider bills a pa ent/payer for a product/service : 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 (RcCffi to esmate 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 (costsffi 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 resul ng 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 Analycal perspecve: impacts what costs/consequences you are interested in Idenfy sources of idenfying drug & healthcare costs o External sources : Published literature/studies : External databases :Websites -- consumer cash pricing o Internal sources : Payer : Hospital, community pharmacy, or other site where eval is occurring Drug pricing Average wholesale price (AWPffi Wholesale acquision cost (WACffi Federal supply schedule (FSSffi
Balancing Costs & Outcomes Describe components of a PE evalua on o Making decisions Costs (beyond drugsffi Pharmaceu cal care Accompanying tes ng Drug-related complica ons Drug treatment failure Treatments (e ects beyond e cacyffi Increased survival Allows pt to go back to work Achieves improved health state Increas