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Biostats > Econ Exam 1 > Flashcards

Econ Exam 1 Flashcards

1
Q

Cost-Minimization Analysis (CMA)

A

compares cost of treatments with equivalent outcomes

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2
Q

Cost-Effectiveness Analysis (CEA)

A

measures costs in dollars and outcomes in natural health units —it is the most common type

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3
Q

Cost-Utility Analysis (CUA)

A

measures costs in dollars and outcomes in quality adjusted life year (QALY)
takes patient preference/satisfactions (utilities) into account
a subset of CEA-outcomes in natural health units

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4
Q

Cost-Benefit Analysis (CBA)

A

compares both costs and benefits in monetary units $
used in wildlife, irrigation and flood control, air quailty

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5
Q

Economics

A

The study of how individuals and societies choose to allocate scarce resources, why they choose to allocate them that way, and the consequences of those decisions.

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6
Q

Microeconomics

A

The study of individual decisions
Suppy,demand, elasticity

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7
Q

Macroeconomics

A

The study of the economy as a whole
-inflation, unemployment -the country

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8
Q

Utility (Satisfaction)

A

Satisfaction obtained from purchasing a particular good or service
if utility of a good is greater than its cost=BUY

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9
Q

Patient Perspective

A

Pays for the costs not covered by insurance companies
-copayments, deductibles and any out of pocket costs

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10
Q

Provider Perspective

A

Pays for the costs of providing products or services
-drugs, hospitalization and lab test

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11
Q

Price

A

the charge

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12
Q

Cost

A

the input

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13
Q

ECHO

A

Economic, Clinical, Humanistic, Outcome

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14
Q

Traditional Cost Category

A
  1. Direct Medical Costs
  2. Direct Non-medical costs
  3. Indirect costs
  4. Intangible costs
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15
Q

Direct Medical Costs

A

most obvious cost to measure
directly related to medical treatment
-diagnostic tests, hospitalization, home infusion, medical visits
ambulance to ER service
buying an OTC cold medicine from a local pharmacy

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16
Q

Direct Non-medical Costs

A

Cost to the patient that are directly associated with treatment but are not medical in nature
Examples: cost of traveling to and from clinic, food and lodging for out of town treatment, child care services
-gas fee spent on the way to clinic where you receive steroid injections
-you order food while waiting for son to finish chemo
-buying plane ticket to care for moms recovery
-uber fee spent

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17
Q

Indirect Costs

A

Result from the loss of productivity due to death/illness
Examples: Missing work, or reduced productivity at work due to treatment
-taking a week off from your work to care for ill mom
-come back to work after knee surgery and are slower

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18
Q

Intangible Costs

A

costs of non-financial outcomes of disease and medial care
examples: nausea from chemotherapy, anxiety during mri scan so take xanax

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19
Q

Consumer price index (CPI)

A

measure of the average change over time in the prices paid by the consumers

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20
Q

standardization of costs

A

bringing past costs to the present
CPI as indicator
MULTIPLY (must always add 1 before)
if CPI=4.4%
change to decimal –> 0.044
then add 1 (1+0.044)=1.044
now can multiply the cost by that

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21
Q

discounting of costs

A

brining future costs to the present
DIVIDE (must always add 1 before)
if Discount rate= 5%
change to decimal –> 0.05
then add 1 (1+0.05)=1.05
now can divide the cost by that

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22
Q

Average Wholesale price (AWP)

A

list price/sticker price
higher than what pharmacies actually pay for the meds
-redbook-micromedex

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23
Q

wholesale acquisition cost (WAC)

A

catalog price
sale deals and discounts/rebates NOT included

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24
Q

average manufacturer price (AMP)

A

amount paid by wholesaler after all sales deals are included
more precise
not available to public

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25
Q

Common sources for US reimbursement rates

A

physician fee reference
medicare reimbursement rates from CMS (Centers for Medicare and Medicaid Services)

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26
Q

Personnel Costs

A

consideration of the amount of time spent by medical personnel (work time)

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27
Q

Hospitalizations

A
  1. per diem
  2. disease-specific per diem
  3. diagnosis related group
  4. micro-costing
    (more precise as you read down)
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28
Q

per diem

A

average cost per day for all types of hospitalizations
(key words: per day, all)

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29
Q

disease-specific per diem

A

estimate the costs based on specific disease state
-appendectomy, cardiac bypass surgery costs, small joint repairs and cataract surgery costs etc.

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30
Q

diagnosis related group

A

classify diagnosis/procedures that use similar resources
control medicare costs
each category has its own reimbursement rate based on: diagnosis, secondary diagnosis, age, sex, and discharge status
each-patient is categorized

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31
Q

micro-casting

A

collects information on resource use for each component of hospitalization
-need to review patients hospital record

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32
Q

Complete title

A

Good Example
 Cost Benefit Analysis of Ibuprofen vs. Tylenol in Pediatric Patients with Common Cold Symptoms
 Bad Examples
 (Pharmacoeconomic Analysis) of Glipizide vs. Glyburide in the Veterans Administration
 Cost-Effectiveness Analysis of (Two Antibiotic) Therapies in a Large Teaching Hospital
 (Ultraceph Found Cost-Effective) When Compared to Megaceph

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33
Q

Clear objective

A

stated in the beginning-usually in objective section
-to calculate the benefit to cost ration
NOT-to determine if better

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34
Q

appropriate alternatives/comparators

A

new vs current
drug vs nondrug
etc

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35
Q

alternatives described

A

what resources? services? and description of drug dose and so on

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36
Q

perspective stated

A

costs for patients, providers and society

37
Q

type of study

A

knowing upfront what type of study is being done ..CBA, CMA etc. and why it is appropriate for the study

38
Q

relevant costs

A

stated perspective for the costs, time period, and justification
protocol driven costs should be excluded

39
Q

relevant outcomes

A

clinically important and appropriate time periods

40
Q

adjustment or discounting

A

assessing resources over years=use adjusted (standardized)
when costs extrapolated more than 1 year out=use discount rate

41
Q

reasonable assumptions

A

may not be precise or universally agreed upon

42
Q

sensitivity analyses

A

more reliability (robustness) for discount rates
if it supports then your study is more credible

43
Q

limitations addressed

A

no PE study is perfect
limitations: small sample size=disturbs reliability
retrospective data collection=disturbs generalization due to potential bias

44
Q

Appropriate generalizations

A

if used specific population then needs to be specified in the study as a caution against generalizing or extrapolating
-age, gender, socioeconomic status, disease state

45
Q

unbiased conclusion

A

dose study make sense?
does the result show no significant difference but the conclusion strongly supports one of the alternatives

46
Q

when analyzing if a good title

A

answer these:
what is being compared?
what type of study is being conducted?
does the title sound biased?

47
Q

Cost-minimizing analysis (CMA)

A

pharmacoeconomic analysis that compares the costs of treatments assuming that they have equivalent outcomes

48
Q

CMA compares: bioequivalent

A

same active ingredients and same desired outcome

49
Q

CMA compares: 2 different settings at the same doses

A

hospital vs home

50
Q

advantages to CMA

A

simplest -only costs of intervention are compared
easy to convince readers-due to equivalent outcomes

51
Q

Disadvantages to CMA

A

types of interventions are limited
less commonly. used

52
Q

cost analysis

A

if outcomes are not measured it is a partial economic analysis and not a full one

53
Q

cost-effective analysis

A

if outcomes are measured it is an cost effective analysis that has the same effectiveness

54
Q

50th percentile

A

median

55
Q

75th percentile

A

75 percent of the charges for that service are equal to or less than that fee nationwide

56
Q

healthcare professional cost

A

costs per minute
gross annual salaries including fringe benefits

57
Q

drug administration cost

A

hospital supply information

58
Q

drug cost of IV and SC formulations

A

unit cost per treatment cycle
US average wholesale price

59
Q

indirect costs

A

allow for more precise results

60
Q

perspective stated?

A

what costs were measured? patients, providers,payers, society (may not say directly but if see costs then choose it)

61
Q

relevant costs?

A

costs were estimated….medical and billing records…..

62
Q

relevant outcomes?

A

includes time period and same efficacy/scope

63
Q

appropiate generalizations?

A

does not generalize/extrapolates but says appear to be similar but differences can be seen

64
Q

cost-effectiveness analysis (CEA)

A

measures costs in dollars and outcomes in natural health units that indicate an improvement in health
most common type

65
Q

advantages of CEA

A

measured in clinical units-familiar and acceptable to clinicians
outcomes do not need to be converted to monetary values
ex: symptom free days, mmHG, %healed, life years saved, rehospitalizations avoided

66
Q

disadvantages of CEA

A

only one outcome at a time can be compared
so keep to mmHg to mmHG not to FEV
interpretation is subjective -is added benefit worth got the added cost

67
Q

uses of CEA

A

cost of mammogram vs prevention of breast cancer
cost of flu vaccine vs. prevention of influenza

68
Q

average cost (Cost effectiveness ratios) CER

A

total cost/ effectiveness (change % to decimal)

69
Q

marginal costs (incremental cost effective ratios (ICER)

A

change in costs/change in benefits (effectiveness,outcomes…)
(C2-C1) / (E2-E1)

70
Q

for ICER calculation

A

must use CCA (cost and outcomes) not CER

71
Q

high cost and same effectiveness

A

not cost effective

72
Q

same cost and higher effectiveness

A

cost effective

73
Q

lower cost and lower effectiveness

A

other factors may be considered to determine the winner

74
Q

if less effective at a higher cost

A

not considered cost effective

75
Q

if more effective at a lower cost

A

it is considered cost effective

76
Q

if more effective but at a higher cost

A

decision maker must decide if the higher effectiveness is worth the higher cost (trade off 1)

77
Q

if less effective but at a lower cost

A

decision maker must decide if the lower cost is low enough to outweigh the lower effectiveness (trade off 2)

78
Q

cost (+)

Quadrant A. Quadrant B
effect (+)
Quadrant C. Quadrant D

A

quadrant B. is known as Trade off 1-decision maker must decide if the higher effectiveness is worth the higher cost
quadrant D= cost effective
quadrant A= not cost effective
quadrant c= Trade off 2-decision maker must decide if the lower cost is low enough to outweigh the lower effectiveness

79
Q

primary outcomes (final)

A

not feasible due to lack of time and monetary resources
ex: cure of a disease, eradication of an infection, life years saved

80
Q

intermediate outcomes

A

surrogate outcomes _labs, FEV1, mmHG, A1C

81
Q

efficacy

A

does the drug work under controlled conditions?
RCTS are essential
before fda approval

82
Q

effectiveness

A

does the drug work in routine medical practices?
after fda approval

83
Q

efficiency

A

how well does it work?

84
Q

elasticity

A

how much the demand changes as the price changes

85
Q

market equilibrium price

A

the point where the supply and demand curves intersect

86
Q

pharmacoeconomics

A

description and analysis of the costs of drug therapy to health care systems
scientific discipline that evaluates the value of products and services

87
Q

humanistic

A

consequences of disease/treatment perceived and reported by the PATIENT

88
Q

4 types of direct medical costs

A

meds, medical services, personnel costs, hospitalizations

Biostats (4 decks)

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