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UMB PEPI
P3 - Exam 2
99
Pharmacology
Professional
11/29/2016

Additional Pharmacology Flashcards

 


 

Cards

Term
IRT/ pat preferences what is the difference between "utility" and "value"
Definition
Utility is UNcertain
Value is CERTAIN
Term
How does descriptive HRQL differ from single utility expression of health status?
Definition
Single provides only a number; therefore we know that pt has QOL degradation in the disease state, but we do not know why (light-headedness, nausea...)
Term
Is cost the same as price or charge?
Definition
No
Term
Define true cost
Definition
cost to bring good or srvc to mrkt
Term
How does paid amount relate to cost?
Definition
an approximation of
Term
economic cost =
Definition
Accounting cost + implicit costs
or/AKA:
Explicit + implicit cost
Term
Describe accounting cost
Definition
The books of the business
Term
Describe Implicit costs
Definition
An implicit cost of owning a building is I have foregone the income from renting that building to someone else
Term
Exceptions to the law of supply and demand
Definition
Giffen goods
Term
Define giffen goods
Definition
Price goes up demand goes up
Term
Describe HTA
Definition
HTA involves comparative studies focused on a health intervention including evaluation of the benefits and effects of any technology or intervention (drugs, devices, procedures, processes).
Term
T/F CEA is a type of HTA
Definition
T
Term
IRT ICER a positive denominator is
Definition
desirable; fewer exacerbations
Term
Describe VBID (Value based insurance design)
Definition
Charge less for drugs to increase adherence
Lose money on drugs, but save on medical expenses
Term
Examples of VBID
Definition
Ashville project
10 city project
Term
Wges apply to ____________, while price applies to __________.
Definition
Humans; goods
Term
Define "Me too" drug
Definition
Not a generic!
A same same but different aka: competition
Term
Types of markets
Definition
Competitive = many sellers
Oligopoly = few sellers
Monopoly = one seller
Monosopy=?
Term
Describe a competitive market
Definition
easy entry/exit
informed consumers
Sellers have negligible market share
Term
Describe the current Pharmacy market structure 2016
Definition
Very Competitive...but mergers are happening Walgreens and Rite Aid!
Term
Generic drug market is
Definition
competitive
Term
Research-based pharmaceutical industry
Definition
Monopolistic...mergers...patents...
Term
GOVT role in pharmacy
Definition
Monitor - FTC
Regulate - FDA
Third party payer - Medicare
Term
Definition of pharmacoeconomics
Definition
Identifies, measures, and compares cost and consenquences of pharm products and srvcs
Term
T/F in the US where we are absolutely the most retard first world nation in terms of healthcare who funds pharmacoeconomic studies
Definition
Pharmaceutic companies
Insurance companies
Term
The new emphasis on PCOR (Patient centered outcome research) may result in
Definition
NIH CMS and FDA funding studies
Term
Can CMS fund cost effective research?
Definition
No - b/c we are retarded
Term
List a billion direct medical costs
Definition
meds; med monitoring; med admin
pt couseling
Dx test
hospitilaization
clinic visit
ER visit
Nursin srvc
Ambulance srvc...
Term
List some direct non-medical costs
Definition
cost of travel
non medical assistance
child care srvc
Term
List some indirect cost
Definition
pt/caregiver loss of productivity
loss of productivity due to death
Term
List some intangible costs
Definition
Pain
Suffering
Fatigue
Anxiety
Term
The many prespectives of cost
Definition
Public insurers, patients, governments, and society are burdened with some form of all the above costs.
Term
Prespectives of cost IRT Private insurers and hospitals
Definition
Direct cost only for the most part
Term
Two alternate means of estimating cost are___________,___________, which is more accurate
Definition
Top down
Bottom up - AKA: micorcosting - more accurate
Term
Per diem v. disease specific per diem
Definition
Per diem - an estimate cost for all pts to stay in the hospital for one day

Disease specific - estimated cost for a DB pt, or a CHF pt to stay in the hospital for one day
Term
NPV (Net present value) r=
Definition
interest rate...essentially... or percent of increase in srvc cost year over year...
Term
HRQoL =
Definition
Health-related quality of Life
Term
3 domains of HRQoL
Definition
Physical
Psychological
Social
Term
Define patient related outcome.
Definition
What the patient perceives as an ideal outcome.Not a number or a scale. AKA: Value.
Term
T/F FDA is not considering PROs from patients on claims
Definition
T
Term
Characteristics of a CMA Cost Minimization Analysis?
Definition
Simplest PECON study
Limited use; reqs alt. to have identical outcomes
Term
When would you use a CMA
Definition
Comparing same generic drugs
Comparing brand to generic
Same drug different settings
Term
When looking at the weird 3X3 matrix CMA applies to which cells
Definition
The center column (4, 6, 9)
4 Reject
6 Accept
9 Nuetral
Term
CEA (cost effective analysis) compares...
Definition
Compares value and costs of all alternatives
Term
Do CEAs require "willingness to pay" data?
Definition
No
Term
T/F CEAs place "value" on outcomes
Definition
F
Term
T/F CEAs can measure outcomes in various units
Definition
T
Term
T/F CEAs can measure tech w/ differ expected efficacy and safety
Definition
T
Term
Regurgitate some CEA examples
Definition
1. 2 LDL drugs. A works better and cost more than B
Term
Is mortality and morbidity ever considered equal in these silly studies
Definition
no
Term
The results of a CEA are represented by
Definition
CER
ICER
Term
How do CER and ICER differ?
Definition
CER - drug to placebo
ICER drug to existing treatment
Term
Results of a CER answer___________, while the results of an ICER answer blank.
Definition
CER - should we treat
ICER - Which treatment is better
Term
ICER Equation
Definition
(CostB-CostA)/ (EffectB-EffectA)
Term
IRT the silly 3X3 Matrix identify each "axis" b/c I feel like the labelling is all jacked up
Definition
X = effectiveness
Y=Cost
Term
Challenges and limitations of a CEA
Definition
Need more information from decision makers
Not transparent
Do not know the comparators
Part I of a multi-part decision
Term
What does INB (Incremental Net [Monetary] Benefit) add to a CEA?
Definition
landa
CEA data + landa
Now we know the cost willing to pay
Term
The INB Equation
Definition
(Landa* change in effects)-(change in cost)
Term
One thing about landa IRT INB
Definition
We still need to quantify
Term
Define CUA (Cost Utility Analysis)
Definition
A CEA with QALY adjustment factor
Term
Two drugs have different outcomes, but similar side effects use which type of thinger?
Definition
CEA
Not CUA b/c no need to QALY adj
Not CBA b/c differ outcomes
Term
3 different ways utility can be assigned to a CUA (no consensus)
Definition
1. Rating Scale
2. Standard Gamble
3. Time tradeoff
Term
T/F when assigning utility to a CUA using people from the general population will avoid bias
Definition
T
Term
Limitations of CUA
Definition
1. still using willing ness to pay data
2. the accuracy of utility values
Term
An advantage of a CBA is that it allows us to compare
Definition
compare treatments and programs with unrelated outcomes
Term
CBA example
Definition
Cost of implementing tx < value of benefit?

$ for outcome > $ of cost
Term
Limits of the CBA
Definition
1. Death panels; have to place value on human life or disease prevention
Term
When we say indirect benefit we are talking about
Definition
productivity effects
Term
When we say direct benefits we are talking about
Definition
Savings from medical/non-medical source
Term
When we say intangible we are talking about
Definition
things like pain and suffering
Term
Human capital method assigns value to
Definition
indirect benefits; wages lost/gained
Term
HCM (Human Captiol Method) equation
Definition
indirect benefit = wages gained-wages lost
Term
Advantage of HCM
Definition
Easy to measure
Varitey of sources available for income data
Term
Disadvantage of HCM
Definition
Bias toward special population
Assuming benefit=economic productivity
Does NOT account for intangible benefits
Term
Does HCM account for intangible benefits?
Definition
NO
Term
What are the two methods of assigning value to indirect and intangible benefits
Definition
1. HCM
2. WTP Willingness to pay
Term
T/F WTP accounts for indirect and intaginble benefits
Definition
T
Term
Advantage of HCM
Definition
Easy to measure
Varitey of sources available for income data
Term
WTP uses "contingent valuation" describe this
Definition
Hypothetical situations are presented, and respondent bids or places a value on the intervention and its benefit
Term
T/F WTP assigns a monetary value to indirect and intangible benefits
Definition
T
Term
Avantages of WTP
Definition
Value on intangible benefits
Grounded in preference + economic theory
Term
Disadvantages of WTP
Definition
Hypothetical descriptions
Routes of receiving valuations could induce bias
Respondents have difficulty placing value HCRQoLs
Term
What do cost of illness studies measure
Definition
total economic burden on society
Term
Advantage of COI
Definition
Compare economic impact of different diseases
Determine resources needed...can compare two different countries
Term
Disadvantage of COI
Definition
No standard methodology
Studies on same diseases have different results
Term
Sources of clinical outcome data
Definition
RCT
Claims data
EMRs
Term
Data sources for PRO
Definition
RCT
Survy
EMR
Term
Data sources for utility measures
Definition
Rating scale
Standard Gamble
Time trade-off
Term
Data sources of cost data
Definition
Direct medical costs
Direct non-medical costs
indirect costs
intangible costs
Term
Benefit of EMR data over claims data
Definition
Includes clinical findings
Better dx data
Term
Cons of EMR data
Definition
Cost
Data-missing-ness
Not yet implemented with many providers
Term
Pros of claims data
Definition
large patient samples over large priods of time
dx and servcs tracked
easy focus on specific groups
reflects RWO
Cheap
Term
Cons of claims data
Definition
Loss of follow up if person leaves the plan
Less reliable dx data
Data only generated if fee-for service
Sophisticated stats to prevent bias
Term
COI Methods
Definition
Sum_All_Medical
Sum_Dx_specific
Matched control
Regression
Term
Describe Sum_all_medical IRT COI studies
Definition
Sums all patient with dx cost
Term
Describe Sum_Dx_Specific IRT COI
Definition
Sums cost of all pts with specific dx
Term
Describe Matched control IRT COI
Definition
Do a Sum_all
Subt avg cost of sample to find incremental costs
Term
Describe Regression IRT COI
Definition
Do sum_dx ... regression.... beta... ?
Term
Describe the cells of the sill 3x3 matrix
Definition
1-2 Strong dominance for decision
3-6 Weak dominance for decision
7-9 Non dominance for the decision
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