Flashcards in Session 8.1 - Healthcare ecnomics Deck (17)
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?
-CCGs prioritise NICE-approved interventions with unintended consequences
-May be represented by pharmaceutical companies and/or patient groups