s 6 pharmecon eng

8/8/2019 S 6 PharmEcon ENG

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Pharmacoeconomics

Drug Policy Issues for Transitional countries

UzbekistanC. Cashin, R. Laing


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What is PharmacoEconomics

(PE)?

Inputs

Costs

Health

Care

Outcomes


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Pharmacoeconomics (PE)

Compares the costs and consequences(outcomes) of drug therapies andmedical interventions

PE analysis

efficient allocation of limited resources

among competing alternative medicationsand services

biggest bang for your buck, using aquantitative measure


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Costs

What is cost?

How is cost different from price?

Do we know the cost of drugs?


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Costs

Direct costs: costs to deliver services topatient; both medical and non-medical

Indirect costs: cost of treatment topatient or society

Intangible costs: quality of life


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Costs can be described in many

ways Cost / unit (cost/tab, cost/vial)

Cost / treatment

Cost / person

Cost / person / year

Cost / case prevented Cost / life saved

Cost / DALY (disability-adjusted life year)


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Outcomes

Both positive and negative outcomesshould be addressed

Positive outcomes: drugs efficacymeasure

Negative outcomes: ADR and treatment

failure


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Perspective

Point of view from which the study istaken

Determines what will be measured,what are the costs and benefits, andhow they will be valued

Guides and limits application of study

results

What are the possible perspectives inPE studies?


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Pharmacoeconomic Methods

Cost-minimization analysis (CMA) assumes equal outcomes

Cost-effectiveness analysis (CEA) measures outcomes in natural/physical

units

Cost-utility analysis (CUA)

measures outcomes in QALYs Cost-benefit analysis (CBA)

measures both benefits and costs in $$$


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Cost-Effectiveness Analysis

Used to evaluate cost and outcome oftherapy

outcome measure in non-dollar units

Results expressed as cost-effectiveness ratio

cost/treatment

cost/outcome

cost/life saved


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Cost-Effective

Cost-Effective is NOT the leastexpensive

Less expensive and at least as effective

More expensive with an additionalbenefit worth the additional cost

Less expensive and less effective

extra benefit provided by competingtherapy is not worth the extra cost


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Decision Making

Hi r t r t

Hi rff ti

rff ti


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Available Sources ofData for

Pharmacoeconomic Analysis Stock / Purchasing Records

trends and changes in usage

ABC analysis

Adverse Drug Reaction Program Data identify areas to study

Non-Essential / Non-FormularyMonitoring

Effectiveness from clinical trial data


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Incremental Cost Analysis

(ICA) When comparing 2 therapies, ICA

assesses what the added cost per net

effect for alternative therapy would be

ICA is the difference in total costs of 2

therapies divided by difference ineffectiveness of the 2 therapies


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Example

Therapy A: costs $2500 and saves 10 lives

C/E ratio= $250/life saved

Therapy B: costs $5000 and saves 15 lives

C/E ratio= $333/life saved

ICA: $5000-$2500 or $500/life saved

15-10


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Sensitivity Analysis

How sensitive are the results to differentvalues of key variables

What if scenarios, e.g.,

a. Assume different cost of drug oroutcome

b. Assume different probability ofan outcome


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Conclusions

Pharmacoeconomics can guide choicesamong alternative medications, treatmentregimens and services based on acombination of costs and outcomes.

Results and interpretation of

pharmacoeconomic studies are influenced bythe perspective of the studythere is no oneright answer.

s 6 pharmecon eng

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