Cost and Costing in Pharmacoeconomics (Final)

pharmacoeconomics

defines, measures, and compares the costs and consequences of pharmaceutical products and services

provides a way to a measure "value of money" for all stake holders

Why is a pharmacoeconomics important?

pharmaceutical care

patient-centered, outcomes-oriented pharmacy practice that requires the pharmacist to work in concert with the patient and the patient's other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that

the medical model

-Mortality: a fatal outcome, death

-Physical and biological measures: BP, weight...

-Diagnostic test results: white blood cell count, serum cholesterol...

-Definable clinical events: stroke, heart attack...

Rationales for the medical model

-Useful in diagnosis and treatment

-Well-accepted by health care providers

Limitations of the medical model

May be multi-system (e.g. diabetes with complications), but only one-dimension

humanistic outcomes

Consequence of disease or treatment on patient’s functional status or quality of life: psycho-social and physical functioning, general health, well-being, and satisfaction

patient-reported outcome (PRO)

the measurement of any aspect of a patient's health status that comes directly from the patients

clinical-reported patient outcomes

-General impressions

Observation and test of functions

-Pharmacists as a source for outcomes

Patient-reported outcome (PRO)

-General perception of health

-Functional status

-Well-being

-symptoms

-Health-related quality of life

-Satisfaction with service

-Adherence

-Care preference

cost

resources (inputs) used in the production of a good or service

charge

the price or the amount that is charged to the payer

time horizon (time frame)

Time over which the pharmacoeconomic alternatives are evaluated

morbidity

condition resulting from the ailments associated with the disease

intangible cost

Costs associated with non-financial outcomes of disease and medical care (such as quality of life), which cannot be properly expressed in monetary terms

1.Identification of costs relevant to study

2.Measurement of resources used (Q): physical quantities

3.Valuation of resources (C = Price x Q)

What are the 3 tasks of costing?

costing

is the process of identifying the costs of a disease and/or its associated treatment, and of breaking them down, and relating them to the various aspects of the disease and treatment

macro-costing

use of relatively large groups or bundles of cost

micro-costing

each component of resource use

(e.g., lab tests, days of stay, drugs) is estimated

and a unit cost derived for each item

diagnosis-related groups (DRG)

gives the cost for each category of

case or hospital patient. Takes account of length of stay. Precision

depends on the level of detail in specifying the types of cases

Disease-specific per diem

gives the average daily cost

for treatments in each disease category. These may still

be quite broad

Average per diem

averages the per diem over all

categories of patient. Available in most health

care systems

micro-costing

What is the most precise costing?

average per diem

What is the least precise costing?