intro to health economics

Question 1

health economics definition

Answer 1

the application of discipline and tools of economics to the subject matter of health

Question 2

cost benefit analysis definition

Answer 2

compare monetary value of benefit to cost

Question 3

cost effectiveness analysis definition

Answer 3

which option achieves the desired outcome most efficiently

Question 4

cost minimisation analysis definition

Answer 4

which option has the lowest cost

Question 5

cost utility analysis definition

Answer 5

which option is the most efficient way to increase QALYs

Question 6

what are the 4 principles of health economics

Answer 6

resources are finite
wants/needs are potentially infinite
choices should be made as we don’t have the reosurces to do everything
economists look at costs and benefits of alternative patterns of resource allocation

Question 7

what is opportunity cost?

Answer 7

the value of the benefit forgone because by spending the resource in one way, the next best alternative can no longer be provided

Question 8

what is implicit rationing

Answer 8

care is limited, but neither decisions nor the bases for those decisions are clear, as is the reasoning behind the reasoning for those decisions

Question 9

what is explicit rationing

Answer 9

care is limited, and the decisions are clear as is the reasoning for them

Question 10

what is economic evaluation?

Answer 10

the comparitive analysis of alternative courses of action in terms of both their costs and consequences
estimations of costs and effects

Question 11

what should economic evaluation always compare and why?

Answer 11

healthcare programme with an alternative
measures the benefits produced by the alternatives, measures the costs to provide alternatives
results should include benefits and costs

Question 12

what is a QALY?

Answer 12

quality adjusted life year
multidimensional as to capture aspects of health allowing for comparison between treatments
combine quality and length of life
weigh different aspects of health to allow comparisons
1 qALY is a full year in health

Question 13

what does ICER stand for?

Answer 13

incremental cost effectiveness ratio
(cost per QALY)

Question 14

how is the ICER used

Answer 14

compare ICER to the cost effectiveness threshold to show value for money
if the QALY costs less than 20000£ it is deemed good value for money by NICE

Question 15

what are costs for health sectors

Answer 15

all costs of programme being considered, including cost of initial programme and costs incurred or saved as a result of the programme

Question 16

what are costs for patients and families?

Answer 16

out of pocket expenses
OTC medications
equipment
fares
time of patient and or informal carers
could be work or leisure time

Question 17

should productivity costs be included in economic evaluation?

Answer 17

dependent upon viewpoint
potential double counting - morbidity costs are argued to be captured by utility measure
comparability with other studies
provide a good reason why they should be included and report separately from other results

Question 18

explain cost effectiveness analysis

Answer 18

cost in monetary units
consequences in non monetary units
consequences measured on a unidimensional scale

Question 19

what is incremental benefit in regards to MACE

Answer 19

a per-patient mean reduction in MACE events

Question 20

what is incremental cost in regards to MACE

Answer 20

average cost increase by £600 in intervention group and longer treatment time and more consumables

Question 21

pros of CEA

Answer 21

relatively simple to do
often used outcome measures which are routinely collected/meaningful in a particular field or to decision makers
as measures are likely to be specific to disease or problem then they may be more sensitive

Question 22

CEA cons

Answer 22

not comprehensive - outcome is unidimensional so cannot incorporate other aspects of outcome/health in CE ratio
comparability - interventions with different aims cannot be compared with one another
interpretation - not always clear what value of outcome is and method assumes outcome is worthwhile
primarily addresses the technical efficiency and cannot determine optimal budget level

Question 23

what is cost minimisation analysis?

Answer 23

uncertainty about differential costs
all relavent outcomes are equivalent
least costly option is most effective

Question 24

what is cost utility analysis?

Answer 24

outcome measure is generic
encompasses mortality and morbidity
QALYs most frequently used

Question 25

when is CUA appropriate

Answer 25

QoL is an important outcome
morbidity and mortality are affected
wide range of different outcomes are relavent
you wish to compare costs and benefits to other interventions

Question 26

what are the 5 dimensions of EQ-5D

Answer 26

mobility
self care
usual activities
pain discomfort
anxiety/depression

Question 27

CUA pros

Answer 27

extends CEA to incorporate QoL
multidimensional so can allow comparison of trade-offs
comparability between HC programmes
can be valued so clearer which outcome is worth and what represents value for money

Question 28

CUA cons

Answer 28

limited to health benefits so many items not valued like knowledge
comparability within health care sector only
cannot determine optimal size of healthcare budget
utility of health related QoL not straight forward to estimate

Question 29

explain cost benefit analysis

Answer 29

costs in monetary value
consequences measured in monetary value
valuation of nonhealth benefits
efficiency is expressed as benefit minus cost
relevent to any level of efficiency
overall objective is to maximise net benefit from

Question 30

4 methods of monetary valuation

Answer 30

revealed preference approaches
human capital approach - value of production
court awards - death/injury
wage-risk approach