ESSENTIALS OF PHARMACOECONOMICS

Karen L. Rascati, PhD

Eckerd/Turley Centennial Professor of Pharmacy Administration University of Texas College of Pharmacy Austin, Texas

i Wolters Kluwer Lippincott Williams & Wilkins

Health Philadelphia Baltimore New York London Buenos Aires Hong Kong Sydney Tokyo

CONTENTS

Part I Basic Topics

Chapter 1

Introduction
PharmacoeconomicsWhat Is It? Why is Pharmacoeconomics Important? Relationship of Pharmacoeconomics to Other Research Types of Pharmacoeconomic Studies
SUMMARY QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 2
f /

1
2 2 3 4
7 7 8 8 .

Measuring and Estimating Costs Costing Terms J Cost Categorization Alternative Method of Categorization Perspective Timing Adjustments for Costs Resources for Cost Estimations
SUMMARY QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 3

9 10 10 12 13 13 17
22 22 23 23

Critiquing Research Articles Appropriateness of Methods of Analysis Questions to Use When Critiquing Research Articles
SUMMARY QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 4

25 26 26
32 32 33 34

Cost-Minimization Analysis Overview of Cost-Minimization Analysis

SUMMARY

35 36
37

Composite Article: CMA

QUESTIONS/EXERCISES REFERENCE SUGGESTED READINGS

38
43 45 45

XI

CONTENTS

Chapter 5

Cost-Effectiveness Analysis
Overview of Cost-Effectiveness Analysis Presentation of Costs and Effectiveness Cost-Effectiveness Grid Cost-Effectiveness Plane Intermediate Outcomes versus Primary Outcomes Efficacy versus Effectiveness Consensus and Debate
SUMMARY

47
48 48 49 51 55 56 56
57

Composite Article: CEA

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 6

57
65 65 65

Cost-Utility Analysis (CUA)

Overview of Cost-Utility Analysis Steps in Calculating QALYs
SUMMARY '

67
68 68
73

Composite Article: CUA

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 7

78
85 86 87

Cost-Benefit Analysis
Definition and History Advantages and. Disadvantages of Cost-Benefit Analysis Conducting a Cost-Benefit Analysis Difference Between Costs Versus Benefits Measuring Indirect and Intangible Benefits Calculating Results of Costs and Benefits
SUMMARY

89
90 90 91 92 93 98
100

Composite Article: CBA

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 8

101
108 109 109

Health-Related Quality of Life: Health Status Measures

Definitions Health-Related Quality of Life: Utility Measures versus Health Status Measures Domains of Health Status Assessing Health Status Instruments Pharmacoeconomics and Health Status Measures Patient-Reported Outcomes
SUMMARY

111
112 112 115 117 119 120
120

Composite Article: HRQOL

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS :

121
128 132 134

CONTENTS

xiii

I
Chapter 9

PART II Advanced Topics

Decision Analysis What is Decision Analysis? Steps in Decision Analysis Threshold Analysis
SUMMARY

135 136 136 140

143

Composite Article: Decision Analysis

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 10

145
152 153 153

Markov Modeling Overview of Markov Modeling Steps in Markov Modeling Disadvantages of Markov Modeling Advanced Issues
SUMMARY

155 156 156 162 163

164

Composite Article: Markov Modeling

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 11

165
173 175 175

Retrospective Databases Overview of Retrospective Databases Randomized, Controlled Trials Observational Studies Advantages and Disadvantages of Randomized, Controlled Trials Advantages and Disadvantages of Observational Studies Types of Retrospective Databases . . -s Critiquing Retrospective Database Studies
SUMMARY

177 178 178 178 178 179 181 184

185

Composite Article: Retrospective Database

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 12

186
193 194 195

Pharmacy Services What Are Pharmacy Services? History of Pharmacy Services Review of the Research Issues in Valuing Pharmacy Services Medicare Medication Therapy Management .
SUMMARY

197 198 198 198 201 202

204

Composite Article: Pharmacy Services

QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS

205
212 213 2t5

CONTENTS

Chapter 13

International Perspective
Health Care Expenditures Comparability of Pharmacoeconomic Results Between Countries History of Pharmacoeconomic Guideline Development
SUMMARY QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS Chapter 14

217
218 218 218
223 224 225 226

Future Issues Application of Pharmacoeconomics in the United States Federal Agencies Private Health Care Plans Barriers to Pharmacoeconomics in the United States Other Future Issues
SUMMARY QUESTIONS/EXERCISES REFERENCES SUGGESTED READINGS '.

227 228 228 229 230 231

233 234 234 235

Glossary Index

. 237 243