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Principles of Pharmacoeconomics
Содержание
- 1. Principles of Pharmacoeconomics
- 2. Cost DeterminationLecture 2
- 3. ObjectivesCompare and contrast direct, indirect, and intangible
- 4. ObjectivesGiven a specific perspective, identify all relevant
- 5. Cost DataMeasurement of resource use
- 6. Direct Medical Costs Cost DataComponents of
- 7. Direct Medical Costs (Medications, hospital days, tests, procedures, etc.)Cost DataComponents of Cost
- 8. Other Direct (non-medical) CostsCost DataComponents of Costexpenditures
- 9. Cost DataComponents of CostOther Direct (non-medical) Costs(transportation
- 10. Cost DataComponents of CostIndirect CostsUnpaid resource commitment. Cost of morbidity and mortality.
- 11. Cost DataComponents of CostIndirect Costs(Unpaid assistance, days lost from work, decreased productivity, etc.)
- 12. Intangible Costs(Pain, suffering, etc.)Cost DataComponents of Cost
- 13. Direct Medical Costs (Medications, hospital days, tests,
- 14. Cost TerminologyVariable costs vs. fixed costsTotal Cost:
- 15. ACMCTreatmentCostsAverage Vs. Marginal CostsProportion of Patients Treated0.01
- 16. Specifying the InputsDevelop comprehensive list of ALL
- 17. Payer PerspectiveDirectIndirectAsthma management service
- 18. HospitalizationsLaboratory costsMedications Medical devisesPhysician / pharmacist feesPayer PerspectiveDirectIndirectAsthma management service?
- 19. DirectIndirect (overhead / accounting costs)Provider PerspectiveCommunity pharmacy
- 20. DirectIndirect (overhead / accounting costs)Maintenance UtilitiesMortgage /
- 21. Patient PerspectiveDirect IndirectAsthma management service
- 22. Co-pays, education, insurance premium, transportation, prescriptions, sitters missed work, sittersPatient PerspectiveDirect IndirectAsthma management service
- 23. Societal PerspectiveDirectIndirectAsthma management service
- 24. healthcare costs,e.g. premiums,Medicare & Medicaid, Taxes, Medication
- 25. Counting UnitsDetermine the unit of use for
- 26. Assigning Dollar ValuesOpportunity costs Vs. market pricePersonnel
- 27. Example of Hospital Costs and Charges
- 28. Sources of Cost DataPrimary data collection methodsClinical
- 29. Adjusting for Differences in the Timing
- 30. DiscountingNowPastFutureAccount for InflationDiscount future costs
- 31. Taken from: http://www.orst.edu/dept/pol_sci/fac/sahr/mill00.htm without permission
- 32. Net Present Value (Amount equivalent to $1000 in 2000)Go to Discounting Worksheet
- 33. DiscountingWhat rate do you use?HH Bonds4% (fixed
- 34. Allowing for UncertaintyWhat if the type and
- 35. Purchase cable serviceDo not purchase cable serviceExampleNeed
- 36. Questions
- 37. Скачать презентанцию
Cost DeterminationLecture 2
Слайды и текст этой презентации
Слайд 1Principles of Pharmacoeconomics
Kem P. Krueger, Pharm.D., Ph.D.
Kimberly Braxton Lloyd, Pharm.D.
Auburn
University
Слайд 3Objectives
Compare and contrast direct, indirect, and intangible costs
Describe the relationship
between marginal and average costs
Describe the five steps involved in
determining the cost of therapy or service
Слайд 4Objectives
Given a specific perspective, identify all relevant costs that should
be included in an analysis
Identify at least five sources of
cost dataDiscuss the differences between costs and charges
Explain why discounting is necessary and perform the discounting calculation
Слайд 6Direct Medical Costs
Cost
Data
Components of Cost
expenditures on tangible
health care products or services, which contribute to the gross
national product
Слайд 7Direct Medical Costs
(Medications, hospital days,
tests, procedures, etc.)
Cost
Data
Components
of Cost
Слайд 8Other Direct (non-medical) Costs
Cost
Data
Components of Cost
expenditures on tangible products
or services, which contribute to the gross national product. They
are needed to obtain care, but they do not directly contribute to health care.
Слайд 9Cost
Data
Components of Cost
Other Direct (non-medical) Costs
(transportation to the doctor’s
office, hiring a
baby sitter so a parent can visit
the doctor, etc.)
Слайд 10Cost
Data
Components of Cost
Indirect Costs
Unpaid resource commitment. Cost of morbidity
and mortality.
Слайд 11Cost
Data
Components of Cost
Indirect Costs
(Unpaid assistance, days lost
from work,
decreased
productivity, etc.)
Слайд 13Direct Medical Costs
(Medications, hospital days,
tests, procedures, etc.)
Intangible Costs
(Pain,
suffering, etc.)
Cost
Data
Measurement of resource use
Indirect Costs
(Unpaid assistance, days lost
from work, decreased
productivity, etc.)
Other Direct (non-medical) Costs
(transportation to the doctor’s office, hiring a
baby sitter so a parent can visit the doctor, etc.)
Слайд 14Cost Terminology
Variable costs vs. fixed costs
Total Cost: Sum of all
health care expenditures for entire population
Marginal Costs: The cost to
produce one more unit of outcome (i.e. the cost to successfully treat one additional patient)Average Cost:
(total cost of treatment)
(total # of patients treated)
Link to avg cost worksheet
Слайд 16Specifying the Inputs
Develop comprehensive list of ALL relevant inputs (i.e.
resources consumed) to produce a given output or consequence
The list
will be determined by the perspective of the analysisCommon to all forms of economic evaluation
Слайд 18
Hospitalizations
Laboratory costs
Medications
Medical devises
Physician / pharmacist fees
Payer Perspective
Direct
Indirect
Asthma management service
?
Слайд 19Direct
Indirect (overhead / accounting costs)
Provider Perspective
Community pharmacy providing
asthma management
services
Note: Cost categories were taken from
Brad Stoltz’s 2001 Pharm.D.
project
Слайд 20Direct
Indirect (overhead / accounting costs)
Maintenance
Utilities
Mortgage / rent
Business licenses
Office supplies
laundry,
haz. waste disposal, etc.
Equipment / leases
Fees
Education
Marketing
Dedicated personnel
Provider Perspective
Community pharmacy
providing asthma management services
Note: Cost categories were taken from
Brad Stoltz’s 2001 Pharm.D. project
Слайд 22
Co-pays,
education,
insurance premium,
transportation,
prescriptions,
sitters
missed work,
sitters
Patient
Perspective
Direct
Indirect
Asthma management service
Слайд 24
healthcare costs,
e.g. premiums,
Medicare & Medicaid,
Taxes,
Medication R&D,
Healthcare workforce,
lost productivity,
lost wages
Societal Perspective
Direct
Indirect
Asthma cost of illness
Слайд 25Counting Units
Determine the unit of use for a given resource
(e.g., hospital day, single lab test, 30-day supply of medication)
Determine
how many units will be consumed over the study period
Слайд 26Assigning Dollar Values
Opportunity costs Vs. market price
Personnel time / costs
Medication
costs
Physician and other services
Hospital / emergency department costs
Based upon
cost accounting system
Слайд 28Sources of Cost Data
Primary data collection methods
Clinical trials
Naturalistic trial /
observation cost / accounting system
Secondary data collection methods
Administrative / claims
databasesLiterature / published AWP
Expert opinion
Model
Decision analytical
Statistical
Слайд 29Adjusting for Differences in
the Timing of Costs
A cost or
benefit today is not equivalent in value to the same
cost or benefit in the futureConsider amount of money that would have to be set aside today to get predetermined amount in the future
What rate do you use?
Слайд 33Discounting
What rate do you use?
HH Bonds
4% (fixed rate)
EE Bonds
5.73% (based
on 90% of 5 yr avg Treasury securities yield)
I Bonds:
3.6% (fixed rate + 3.89% variable (inflation-based) rate)
= 7.49%
Source: Federal Reserve Bank of New York http://www.publicdebt.treas.gov/sav/sav.htm (accessed 8/29/00)
Слайд 34Allowing for Uncertainty
What if the type and number of resources
included in the analysis change?
What if a different discount rate
is used?Sensitivity analysis is the technique of systematically varying key variables in an analysis to determine if the results of the analysis change. (This will be covered later).
Слайд 35Purchase cable
service
Do not purchase
cable service
Example
Need
a TV
Purchase a
32”
TV
Purchase a
20” TV
Purchase cable
service
Do not purchase
cable service
Go to
cost determination worksheet
