The methodical instruction
For practical LESSON of the student
Lesson #3 (6 hours)
Methods of pharmaceconomic
evaluation: Cost of Illness, Cost-Minimization Analysis, Cost-Effectiveness
Analysis
The purpose: master the technique of
conducting pharmacoeconomic evaluation by methods
Cost of Illness, Cost-Minimization Analysis, Cost-Effectiveness Analysis.
Vocational counselling
of students: Pharmacoeconomic analysis is the basis of pharmacoeconomics. When conducting pharmacoeconomic
analysis in comparative terms studying financial resources, medical technology
and the results of therapy. Currently in the world practice uses several
different methods of pharmacoeconomic analysis. The
basis of the analysis of the Cost of Illness is counting all the costs of treatment
with one or other pathology. Pharmacoeconomic method
Cost of Illness - one of the simplest and most available methods. Analysis of
"cost-effectiveness" is often used in pharmacoeconomic
analysis and allows to compare the costs of various
medical technologies, characterized by biological changes.
Students’
Independent Study Program
1 Methods of pharmaceconomic evaluation
3.1 Cost of Illness
3.1.1 Approaches
3.1.2 Methods
3.2 Atopic Dermatitis
3.2.1 Therapy-Specific Cost
3.2.1.1 Topical Corticosteroids
3.3.2.2 Topical Immunomodulators
3.4 HPV
6.1 Cost-Minimization Analysis
6.1.1 What is Meant by Therapeutic Equivalence?
6.1.2 Optimizing Evidence from Clinical Trials
6.2 Sources of Clinical Trial Evidence
6.2.1 Superiority Trials
6.2.2 Equivalence Trials
6.2.2.1 Characteristics of Equivalence Trials
6.2.2.2 Equivalence Range or Margin
6.2.3 Non-Inferiority Trials
6.2.3.1 Characteristics of a Non-Inferiority Trial
6.2.3.2 Non-Inferiority Range or Margin
6.3 Other Issues To Be Addressed In Evaluating
Equivalence
6.3.1 Statistical versus Clinical Significance
6.3.2 Equivalence in Single or Multiple Outcomes?
6.3.3 Whose Views of Clinical Equivalence Should be
Preeminent?
6.3.4 Over What Period Should We Evaluate Clinical Equivalence?
6.4 Effectively Targeting the Use of CMA
7.1 The Rationale for Cost-Effectiveness Analysis
7.2 The Cost-Effectiveness Plane
7.3 Basic Components of a Cost-Effectiveness Analysis
7.3.1 Enumeration of the Options
7.3.2 Perspective of the Analysis
7.3.3 Time Horizon
7.3.4 Scope of the Analysis
7.3.5 Measuring and Valuing Costs
7.3.6 Measuring and Valuing Outcomes
7.3.7 Time Preference
7.3.8 Choice of Analytic Modeling Method
7.3.9 Accounting for Uncertainty
7.4 Calculation of Incremental Cost-Effectiveness Ratios
7.4.1 Dominance and Extended Dominance
7.4.2 Sensitivity Analysis
7.4.3 Interpretation of CEA Results
Practical work (9.00 - 12.00)
TECHNIQUE OF PERFORMANCE OF PRACTICAL
WORKS
Work 1. To calculate
cost of illness of the patient with rheumatoid arthritis during the year:
Cost of treatment:
Ø Cost of Ds procedures – 138
Ø Cost of medicines – 255
Ø Cost of medical staff – 70
Ø Cost of hospital treatment – 760
Ø Cost of rehabilitation period – 880
Calculate the tariff of patient
treatment, given that the cost of
treating these 5-th patients is: 1460 UAH., 1490 UAH., 1518 UAH., 1570 UAH., 1543 UAH.
Work 2. Calculate
cost of illness of
the patient with a broken leg, given the following data:
|
Kind of expenditures |
Cost of one procedure |
Multiplicity of performance |
|
One day of staying in hospital |
42 |
21 |
|
Transportation costs |
10 |
2 |
|
Medical examination |
||
|
Physician |
8 |
2 |
|
Neurologist |
9 |
3 |
|
Surgeon |
10 |
2 |
|
Diagnostic procedures |
||
|
X-ray |
15 |
4 |
|
CBC |
5 |
3 |
|
Blood biochemistry |
10 |
2 |
The cost of treatment – 230 UAH.
The cost of
supporting materials – 145 UAH.
The cost of
outpatient treatment – 180
ãðí.
Work 3. Medicinal product A
(efficiency 74%), the cost of treatment by it is 63 UAH. 80 kopecks. The costs
of treatment by medicinal product B is 29 UAH. 15 kopecks, but its efficiency
is 50% less than drug A. The safety of both drugs is approximately the same.
Evaluate medications for processing formulary list of health care
establishment, select an alternative drug for the treatment of nosology.
Work 4. Calculate the
coefficient of "cost-effectiveness" for patients with hypertension,
given that the average dose of propranolol, which normalizes blood pressure for
4 weeks is 21.5 mg, course treatment cost is 170 UAH. The number of patients
with a positive effect is 42.
K=D*N×28/Q
K – coefficient
"cost-effectiveness";
D – average
dose of preparation;
N×28 – course
treatment cost;
Q – number
of patients with positive result.
Work 5. Using pharmacoeconomic analysis of "cost-effectiveness"
to conclude whether the inclusion of one of the medicines in the form of health
care setting.
Efficiency of preparation and cost of preparations A
and B.
|
|
Preparation À |
Preparation B |
|
Efficiency |
70% |
35% |
|
Cost |
100 UAH |
10 UAH |
Using data of table
to calculate the incremental index and make conclusions.
Seminar discussion of theoretical
questions and practical work - 12.30 – 14.00
Initial level of knowledge and abilities
– 14.15 – 15.00
Students must know:
1.
Cost of Illness.
2.
Cost-Minimization
Analysis.
3.
Superiority
Trials.
4.
Equivalence
Trials.
5.
Non-Inferiority
Trials.
6.
The Rationale
for Cost-Effectiveness Analysis
Students should
be able to:
1.
To make calculations for Cost of Illness, Cost-Minimization and Cost-Effectiveness Analysis.
The author: Truhybchak
O.V.
It is approved on faculty meeting
on .
Protocol #