RESP - A. HEALTH ECONOMICS-COVERED

Question 1

what is an economic evaluation

Answer 1

• compares the costs and benefits of 2 or more alternative interventions (drugs)
• inputs (costs of drugs, time used)
• outputs (benefits)

Question 2

what are the 4 outcome categories used

Answer 2

1. effectiveness
2. quality of life
3. utility
4. expressing benefits as monetary value (willingness to pay)

Question 3

Effectiveness

Answer 3

• the outcome of an intervention or service measured in natural units

ie
- cases successfully diagnosed or treated
- mortality
- life years saved
- life years gained

can use clinical indicators
- pain free days
- change in infection rate
- % reduction in blood pressure
- effect on nausea and vomiting frequency

• efficacy: how well drug performs when all other areas controlled
• effectiveness: patient have co-morbidities, will forget meds etc

Question 4

Quality of life

Answer 4

• value attached by public for a specific level of health status or a specific health outcome

factors affecting impact on QoL:
- functional: day-to-day tasks
- social: see friends
- psychological: pain, depression
- cognitive: to think logically
- subjective: carry out things you are thinking

QoL divided into:
1. generic: b/n 2 different interventions used on 2 different disease states
ie: short form - 36 health survey

2. disease specific: used for comparing 2 interventions on same disease
   ie: arthritis impact measurement scale for rheumatoid arthritis
   grip strength and morning stiffness

Question 5

Utility

Answer 5

• value attached by an individual for a specific level of health stated or a specific health outcome
• Quality adjusted life year (QALY) used
• combines morbidity (quality of life) with mortality (quantity of life)
• 1 QALY = 1 year of life in perfect health
• general public best to put a utility value on something - no bias
• ie: difference is utility lost by having pneumonia or, the utility gained by the cure
• can be <0 if fate is worse than death
• EQ-5D has 5 dimensions:
  mobility
  self-care
  usual activities
  pain/discomfort
  anxiety/depression
  3 levels per dimension
  3^5 + death + unconscious possible health states = 245

Question 6

Willingness to pay

Answer 6

• how much an individual would be willing to pay to avoid an illness or obtain the benefits of a treatment
• needs to be greater value than cost of treatment