Tiêu đề 21. PHARMACOECONOMIC EVALUATION.pdf ✅

PHARMD GURU Page 1  The Pharmacoeconomic methods of evaluation are listed in the image below,  These methods can be separated into two distinct categories: 1) Economic 2) Humanistic evaluation techniques  These methods have been used in a variety of fields and arc being applied increasingly to healthcare. ECONOMIC EVALUATION METHODS: The basic task of economic evaluation is to identify, measure, value, and compare the costs and consequences of the alternatives being considered. The two distinguishing characteristics of economic evaluation are as follows:  Is there a comparison of two or more alternatives?  Are both costs and consequences of the alternatives examined?  A full economic evaluation encompasses both characteristics, whereas a partial economic evaluation addresses only one.  Pharmacoeconomic evaluations conducted in today's healthcare settings can be either partial or full economic evaluations. PHARMACOECONOMICS ECONOMIC: COST BENEFIT COST EFFECTIVENESS COST MINIMIZATION COST UTILITY HUMANISTIC: QUALITY OF LIFE PATIENT PREFERENCES PATIENT SATISFACTION PHARMACOECONOMIC EVALUATION
PHARMD GURU Page 2  Application of economic evaluation methods to healthcare products and services, especially pharmaceuticals, might increase their acceptance by healthcare professionals and society.  The methods used most commonly by healthcare practitioners are 1. Cost Minimization Analysis. 2. Cost Benefit Analysis. 3. Cost Effectiveness Analysis. 4. Cost Utility Analysis. 1) COST MINIMIZATION ANALYSIS (CMA):  Cost-minimization analysis is the most basic technique.  Cost-minimization analysis (CMA) involves the determination of the least costly alternative when comparing two or more treatment alternatives.  The two alternatives must be equivalent therapeutically  Once this equivalency in outcome is confirmed, the costs can be identified, measured, and compared in monetary units (dollars).  CMA is a relatively straightforward and simple method for comparing competing programs or treatment alternatives.  CMA shows only a "cost savings" of one program or treatment over another. FOR EXAMPLE:  If drugs A and B are antiulcer agents equivalent in efficacy and adverse drug reactions (ADRs), then the costs of using these drugs could be compared using CMA.  Another example would be prescribing a generic preparation instead of the brand leader. BENEFITS:  Simple method LIMITATIONS:  Outcomes must be equivalent for analysis.
PHARMD GURU Page 3 2) COST BENEFIT ANALYSIS:  Cost-benefit analysis (CBA) is a method that allows for the identification, measurement, and comparison of the benefits and costs of a program or treatment alternative.  The benefits realized from a program or treatment alternative are compared with the costs of providing it.  Both the costs and the benefits are measured and converted into equivalent dollars in the year in which they will occur.  These costs and benefits are expressed as a ratio (a benefit-to-cost ratio), a net benefit, or a net cost. A clinical decision maker would choose the program or treatment alternative with the highest net benefit or the greatest benefit-to-cost (B: C) ratio.  If the B: C ratio is greater than 1, the program or treatment is of value. The benefits realized by the program or treatment alternative outweigh the cost of providing it.  If the B: C ratio equals 1, the benefits equal the cost. The benefits realized by the program or treatment alternative are equivalent to the cost of providing it.  If the B: C ratio is less than I, the program or treatment is not economically beneficial. The cost of providing the program or treatment alternative outweighs the benefits realized by it.  CBA should be employed when comparing treatment alternatives in which the costs and benefits do not occur simultaneously.  CBA also can be used to evaluate a single program or compare multiple programs.  However, valuing health benefits in monetary terms can be difficult and controversial. The expression of some health benefits as monetary units is neither appropriate nor widely accepted.  Therefore, unless the benefits of a program or treatment alternative are expressed appropriately in dollars, CBA should not be employed.
PHARMD GURU Page 4 COST OF THERAPIES DRUG A DRUG B COSTS Acquisition 300 400 Administration 50 0 Monitoring 50 0 Adverse effects 100 0 Subtotal 500 400 BENEFITS Days at work($) 1000 1000 Extra months of life($) 2000 3000 Subtotal 3000 4000 Cost-output ratio 3000/5000 4000/400 6:1 10:1 ADVANTAGES:  Decision making. DISADVANTAGES:  Over-simplistic.  CBA is difficult to perform because it requires both cost and benefits to be measured in monetary terms.  Productivity and quality of life is difficult to perform reliably and meaningfully. 3) COST EFFECTIVENESS ANALYSIS:  The most commonly employed method is cost-effectiveness analysis.  Measures effectiveness (health benefit) in natural units (e.g. years of life saved, ulcers healed) and the costs in money.  It compares therapies with qualitatively similar outcomes in a particular therapeutic area. For instance, in severe reflux oesophagitis, using a proton pump inhibitor compared to using H2 blockers.  CEA does not allow comparisons to be made between two totally different areas of medicine with different outcomes.