Flashcards in Lecture 12 - Pharmacoeconomics of type 2 Diabetes Deck (21):
A csoting study shows...
how much an illness 'costs' the society, but don't give you any information about what to do about it?
What is cost -effective analysis?
Measure outcomes (life years, number of days free from drugs), and cost.
e.g BP drugs in diabetes- $502 for a 0.05 life year increase over remaining lifetimes
answering the question: Is it worth spending the money?
Most of the action in health ecomics has what balance of cost/effect?
new treatments being more costly, but a better effect
e.g Ratio of 10,000 per life year for BP drug diabetes example - quite good by Australian standards
What is QALYs?
Quality adjusted life year
decreases over time
can compare with drug treament the profile of peoples QALYs
Why do we need complex diabetes (disease) simulation models?
It takes time for treatments to work
There are many different types of complications
Many different factors influence the risk of dvelopming complications (BP, idney function)
Helps you answer "what if's" based on a synthesis of available data
Health economists have been developing simulation models since the ____ model of the mid-1990s
What are the common features of simulation models?
Develpoed from literature or data, regarding what is known about epidemiology and clinical progression of disease
Include a series of health states - important in terms of costs or impacts on Quality of Life
Include risk factors
capture outcomes in life-expectancy or QALYs
What is the method of UKPDS OM 1 model:
1. estimate an integrated set of parametric proportional hazard models using UKPDS data
2. Can then predict risk of first occureence of 7 major diabetes-related complications based on patient characteristics
3. Patients start with specific health status can then simulate them through life identifying their complications along the way
events patients endure are rarely ___ of each other - need to consider them together by...
not independent of each other
need to link equations
What are consdierations in adapting studies internationaly
economic assumptions - ethnicities
Price of drugs in different healthcare system - e.g Atorvastatin is $19 in Aus, $2 in new zealand and $3 in england
Generally genetic drugs in Australia are..
waht does this mean for healthcare decisions?
more expensive - bad for the taxpayer, but ..
could use drugs differently, ration then more, try and get the prices down
A high -proportion of health costs of type 2 diabetes are due to...
The make-up of the complication costs differs...
across regions - Asian populations tend to have higher instances of stroke for example
What other important factor is measured differently across natons?
how to measure quality of life
Asian populations consistently report less problems.
Objective health can still cause different
self-assessments from different cultures
Asian poluations tend to have higher rates of ...
stroke, lower of myocardial infarction - so do you need a different model for asian populations in australia? Something that needs to be looked at in the future
Why are we falling down the "patent cliff"
drugs are coming off patent -
druges cheaper so do we expand to peopel of lower risk?
The patent cliff is related to the applciation of models?
low -cost generic drugs (BP< cholesterol) are now affordable in all but the lowest income countries
when should we initiate use and on whom - look at models for cost/benefit analysis
BP drugs are known to be effective in reducing mortalilty
The diabetes drug metformin has been shwon to prevent diabetes - what is a new way of approaching medicine as these drugs become cheaper
give them to patients earlier - can do models assessing the cost/benefit and QALYs saved
True or False
We need to invest more in developing tools like simulation models to assist decision making
does not fit all - need to update and develop