The methodical instruction

 For practical LESSON of the student

Lesson #4 (6 hours)

Indicators of utility of medical technologies. Budget Impact Analysis. Cost-Utility Analysis. Sensitivity Analysis

The purpose: to acquaint students with the essence of pharmacoeconomic analysis of "cost-benefit", its advantages and scope. Teach to conduct calculation of QALY. Conduct pharmacoeconomic analysis of "cost-benefit". Perform a sensitivity analysis of the pharmacoeconomic studies results.

Vocational counselling of students: Pharmacoeconomic analysis of "cost-benefit (Utility)" is considered as a separate analysis of "cost-effectiveness", which focuses on assessing the quality of life due to alternative regimens.

Pharmacoeconomic analysis of "cost-benefit" is more difficult to conduct and less methodically processed. This analysis assesses the costs and outcomes in financial terms.

Students’ Independent Study Program

1 Indicators of utility of medical technologies

1.1 Introduction to Budget Impact Analysis

1.2 Choice Problem

2 Guidelines for Budget Impact Analyses

2.1 Perspective and Target Audience

2.2 Outcome

2.3 Health Condition and Target Population

2.4 The Intervention

2.5 Time Horizon

2.6 Comparators

2.7 Model

2.8 Data Sources

2.9 Calculations

2.10 Reporting of the Results

3 Cost-Utility Analysis

3.1 Background and Introduction to Cost-Utility Analysis

3.2 Case-Study: A Cost-Utility Analysis of a Quadrivalent Human

Papillomavirus Vaccination Program

3.2.1 Background

3.2.2 Research Questions

3.2.3 Disease Model

3.2.4 Screening and Vaccination Strategies and Parameters

3.2.5 Economic Parameters

3.2.6 QoL Weight Parameters

3.2.7 Model Output: Epidemiologic

3.2.8 Model Output: Quality-Adjusted Life Years

3.2.9 Model Output: Economic

3.2.10 Sensitivity Analyses

3.2.11 Epidemiologic Results

3.2.12 QALY Results

3.2.13 Cost-Effectiveness Results

3.3 Commentary

4 Sensitivity Analysis

4.1 Introduction

4.2 PE Guidelines Around the World

4.3 Sensitivity Analysis

4.3.1 Deterministic SA

4.3.2 Probabilistic SA

4.3.3 Scenario Analysis

Practical work (9.00 - 12.00)

TECHNIQUE OF PERFORMANCE OF PRACTICAL WORKS

Work 1. Studies have shown that if the exact implementation of all recommendations regarding diet, work and rest, exercise patient with angina has a chance of living 35 years, including 10 years with the quality of life 0,9, the next 20 years - the quality of life 0, 7 and 5 years - the quality of life 0,5. Calculate for this patient index QALY.

Work 2. Using pharmacoeconomic method of "cost-benefit" compare two alternative treatments for patients with cerebral palsy. For the more usefully method define cost of additional advantage unit.

Characteristics of alternative methods of treatment of cerebral palsy

	І	ІІ
Expenditures for 1 patient	240 UAH	680 UAH
QALY	4	7
CUR
ICUR

Work 3. Give pharmacoeconomic evaluation of alternative medical treatment technologies of prostate cancer using the "cost-benefit".

1methods - radiotherapy: direct medical costs of radiotherapy is 1380 UAH. As a result of treatment, the patient gets a chance to live 7 years with quality of life 0,9 and 6 more months - quality of life 0,7.

Second method - surgery: direct medical costs for surgical treatment is 1800 UAH. As a result of treatment, the patient gets a chance to live 15 years with quality of life 0,9 and 9 more months - quality of life 0,5.

Conduct "cost-benefit" analysis, calculate the cost of an additional unit of benefit (ICUR) using surgical treatment.

Work 4. For patients with cervical osteochondrosis in the neurological department will introduce a new technique of treatment with the use of "Botox" device. Evaluate feasibility of implementing this technique using pharmacoeconomic analysis. The calculations take into account data:

First methods - traditional regimen:

Direct costs of outpatient treatment - 2629 UAH year.

Direct costs for hospital treatment - 4614 UAH year.

Indirect costs - 1985 UAH year.

As a result of treatment, the patient gets a chance to improve the quality of life factor from 0.3 to 0.6 and keep it at that level for a year.

Second method – complex: therapy traditional treatment regimen in combination with physiotherapy procedures with the use of "Botox":

Direct costs of outpatient treatment - 9080 UAH year.

Direct costs for hospital treatment - 4614 UAH year.

Indirect costs - 1985 UAH a year may be negated by increasing the efficiency of the patient as a result of the use of new methods of treatment.

As a result of treatment, the patient gets a chance to improve the quality of life factor from 0.3 to 0.8 and keep it at that level for 6 months, and then another 6 months - at 0.9.

Work 5. Conduct pharmacoeconomic analysis of hypertension monotherapy with ACE inhibitors and sensitivity analysis of the results to changes in prices. The recommended dose of captopril - 100 mg per day. Duration of monotherapy – is 30 days. Efficiency rate of antihypertensive therapy no different.

№ з/п	Name of preparation	Form of medication	Price for package, UAH.
			min	average	max
1	Capoten «BMS»
2	Capozid «BMS»
3	Captopril «KRKA»

Work 6. Make a comparative characteristics of various methods of pharmacoeconomic analysis, organize the specifics of each method in tabular form.

Method

Purpose

Advantages

Disadvantages

Scope

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. Etiology and pathogenesis of disease.

2. Directions pharmacotherapy.

3. Pharmacological groups of drugs.

4. Approaches to pharmacoeconomic analysis.

Students should be able to:

1. Possess and use the necessary documentation and reference books for pharmacoeconomic analysis.

2. Calculate the costs of treating certain diseases.

3. Conduct comparative pharmacoeconomic evaluation of individual drugs and individual treatment regimens.

The author: Truhybchak O.V.

It is approved on faculty meeting

on .

Protocol #