1. Cost Effective Studies
Group 8
Cameron Durlacher, Nicholas Mastromarino, Yudeysi Morejon, Bora Na, Reema Rifaie

2. Objectives
Explain & provide an example of a practical pharmacy cost effectiveness study
Objective of cost – effective studies
Methods
Results
Conclusions

3. Objectives of the Study
Compares the costs and health outcomes of two or more interventions that preform the same task by assessing the extent to which it can be regarded as providing value for its cost.
Consider which interventions produce the greatest value, based in part on economic implications, as well as effectiveness.
Deciding how to allocate health care resources

4. Objectives of the Study
Cost-Effectiveness expressed as a ratio:
( Cost of intervention – Cost prevented by intervention)
Benefit of intervention
Cost of intervention: associated with provided treatment of preventive test i.e hospitalization, drugs
Cost prevented by intervention: avoided future health care cost i.e future hospitalizations, physician visits, drugs
Benefit of intervention: usually associated with increased in both quantity and quality of life due to intervention. Quality adjusted life years is usually what is measured (QALY)

5. Quality-adjusted life-years (QALY’S)
QALY’S = Duration of illness x ( HRQL treated – HRQL untreated) + ( years gained x mean HRQL )
HRQL : Health related quality of life – it’s a score that evaluates life lived in a particular health state
QALY’S : measured using survey instruments
QALY’S is defined as the measure of health improvement that is used to guide health-care resource allocation decisions

6. Methods Utilized in Cost Effective Studies
Interventions that are completely independent – that is, where the costs and outcomes of one intervention are not affected by the introduction
Mutually exclusive – that is, where implementing one intervention means that another cannot be implemented, or where the implementation of one intervention results in changes to the costs and outcomes of another.

7. The Cost-Effective Plane
Less effective and more expensive
Excluded*
More effective and more expensive
Questionable*
Less effective and less expensive
More effective and less expensive
Dominant*
Aims to clearly illustrate differences in costs and outcomes between different strategies
Visual representation on the relative value of the two strategies
Therapy approval for reimbursement and for formulary inclusion
Health technology assessment agencies i.e NICE make their judgment based on the relative cost - effectiveness of therapies

8. The Cost-Effective Plane

9. EXAMPLE: Practical Pharmacy cost-effective study
Ear drop A
Ear drop B
Cost ( US $)
6.50
7.90
Effectiveness
80%
90%
Cost - Effectiveness
US $6.50 to treat 0.8 of one case successfully
US $7.90 to treat 0.9 of one case successfully
Amount (US$) needed to treat one case successfully
6.50/0.8 = 8.125
7.90/0.90= 8.778
Clinical meta-analysis included 4 studies involving a total of 863 participants in observing effectiveness of Ear drop A in comparison to Ear drop B.
Overall, the results indicated that Ear drop B had greater incidence of successful treatment with little to no side effects, whereas Ear drop A was less effective in individuals and a slight increase in incidence of adverse events but was not found to have a significant difference

10. Optimal effectiveness at least expensive
Results
Price
Ear Drop A: $8.1
Ear Drop B: $8.778
Effectiveness
Ear Drop A: More Cost Effective
Ear Drop B: Less Cost Effective
Optimal effectiveness at least expensive
Cost-effective

11. Conclusions of the Study
Cost-effectiveness analysis can indicate which one of a number of alternative interventions representing the best value for money
Useful in the determination on healthcare outcomes:
Determining what should/should not be added to a formulary
Determining standard of care practices
Determining patient care outcomes
Healthcare reform and choosing cost effective healthcare plans

12. References
AH, S. (2015). Affordability and cost-effectiveness: decision-making on the cost-effectiveness plane. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 1 November 2015, from
Bang H, Zhao H. Cost-effectiveness analysis: a proposal of new reporting standards in statistical analysis. Taylor & Francis Group. 2014;24: /
Weinstein MC, Torrance G, McGuire A. QALYs: The Basics. International Society for Pharmacoeconomics and Outcomes Research. 2009;12:S5-S-9.

13. Thank you!