Session 8.1 - Healthcare ecnomics Flashcards Preview

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Flashcards in Session 8.1 - Healthcare ecnomics Deck (17)
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What is healthcare economics?

-Assumes resources are scarce and seeks to provide information to assist in the allocation of resources in an efficient and equitable way


What is opportunity cost?

-Once you have used a resource in one way it is no longer available to use in a different way. The opportunity cost of a tx is the value of the next best alternative use of those resources


when measuring the cost of a treatment, what factors are taken into account?

-Identify, quantity and value of resource needed
-Cost of healthcare
-Cost of patient time
-Cost of care-giving
-Economic cost by employers


What factors are taken into account when measuring the benefit of a treatment?

-Impact on health status
-Savings in healthcare resources
-Improved productivity of patient


What is cost minimisation analysis?

-Outcomes assumed to be equivalent regardless of tx chosen
-Focusses on inputs of resources only ie chooses the cheapest option


What is cost effectiveness analysis?

-Getting most for your money
-Compares interventions with common health outcomes eg lowering bp
-compared in cost per unit outcome eg cost/5mmHG lowered
-Is the extra benefit worth the extra cost?


What is cost benefit analysis?

-Compares everything in money by placing a price on how much it means to the patient
-Compares outputs and inputs
-Willingness to pay


What is the major difficulty of cost benefit analysis?

-Difficult to put a monetary value on non-monetary benefits eg saving lives


What is cost utility analysis?

-A type of cost effectiveness analysis
-Focusses on the quality of health produced/benefits foregone
-Measured in QALY = 1 perfect year of health or 10 years at 0.1 health or 6months of 1 health for 2 people


What is the advantage of using cost utility analysis?

-Using QALYs allows comparisons to be made across different programmes


How is quality of life assessed for QALYs?

-Using questionnaires such as EQ-5D


How is cost utility calculated?

-Cost per QALY gained
-Work out QALY for each treatment
-Work out QALYs gained
-Work out how much it costs per QALY gained from total cost of treatment divided by QALYs gained


Give 3 alternatives to QALYs

-Health Year Equivalents (HYE)
-Saved-Young-Livefe Equivalents (SAVEs)
-Disability Adjusted Life Years (DALYs)


How does NICE use QALYs?

-QALYs integrated with price to determine cost effectiveness
-Below 20K per QALY accepted
-20-30K/QALY judgement takes into account degree of uncertainty, if chalnge in HRQoL has been adequately captured by QALY, any benefits not captured by QALY
-Above 30K needs to be a very strong case


Who is involved in NICE in decided the cost effectiveness of treatments?

-DoH, HCPs, patients, carers and public


What are the concerns of using NICE to decide the acceptance/rejection of treatments?

-Political interference
-CCGs prioritise NICE-approved interventions with unintended consequences
-May be represented by pharmaceutical companies and/or patient groups


Describe some criticisms of QALYs

-Controversy over values
-Doesn't distribute resources according to need but benefits per unit cost
-Disadvantages common conditions-> not allocated a fair impact on health
-Dont assess impact on carers and family