arp[it ppt pe
TRANSCRIPT
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ARPIT JHAWARMBA(PHARM)
Pharmacoeconomics
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COSTCOST
REDUCTION?REDUCTION?
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Flow of presentationIntroduction
Evolution
Viewpoints- Industrial & Government
Pharmacoeconomics and India
Cost ,Modeling & data sources
Pharmacoeconomics methods
Case study
Application and Conclusion
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Pharmacoeconomics refers to the scientific discipline that
compares the value of one pharmaceutical drug /drugtherapy/medical procedures/drug development and
commercialization /healthcare policies & fund allocation
/insurance and reimbursement. Stakeholders in healthcare
system and the related cost
One important consideration in Pharmacoeconomics evaluation
is to decide the perspective from which the analysis should beconducted ,Results altered
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ECONOMIC
EVALUATION
Cost/Outcome
DECISIONS
Alternative-B
Alternative-A
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Evolution of Pharmacoeconomics-
1960s - Pharmacokinetic---studies evolution towards
clinical side
1970s- CBA and CEA introduced into the pharmacyliterature
1990s- Echo model (economic ,clinical and humanistic
outcome)
Applied Pharmacoeconomics emerges
2000- Pe has widespread use and application
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Industry-Pharma industry is highly regulated
Gather drug profile information for regulatoryauthorities
Information to persuade customers is also regulated
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Which projects do we invest in?
How do we maximize the efficiency of the
projects we do?
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Interesting points-
Mckinsey perspectives on
pharmaceutical R&D(2010)
$1.6 billion per new drug
approved
High failure rate + 30% drugs
accepted
Reinvent the invention
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Link between R&D and Sales and
Marketing
Exponential growth + Methodological
sophistication
New chemical entities
Economic studies have indicated
defects in Phase-3 studies
Why????
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Prices increase tremendously as we move todifferent phases in clinical trials
It has been shown that shifting 5% of clinical
failures from phase 3 to phase 1 can reduce the
development costs up to 7%
FDA will demand Pharmacoeconomics
evaluations in future
BMI
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P
Misguide the guide.
Pharma companies can prove their innovative and costly
products that why they are more costly
In September 2009 Pfizer paid $2.3 billion to settle allegations for
Marketing drugs illegally to the physicians(The New England journalof Medicine-May 13-2010)
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Pharmacoeconomics and India-
Infancy stage ,CLINICAL TRIALS + R&D
Opaque and biased drug pricing policy
Counterfeit drug industry
11% of the people are insured
SOURCE BMI
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Positives
An outpatient card at AIIMS costs a one time fee of
10 rupees
Our traditional system of medicine (regulated by Ayush)
Coming of corporate hospitals
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Costs:
1.Direct costs-hospital expenses, physicians fees
etc
2.Indirect costs-Loss of time from work
3.Intangible costsNote we generally do not include indirect costs into cost effective analysis
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Modeling
Simplification of the real world
Clinical trials (economical ,ethical reasons)
High percentage of these models are developed
using commercial software
Electronic medical records and use of inexpensive
computing have made it possible to determine the
advantages and disadvantage of a product
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Data sources
Its very important to get the real world data as it helpshealth economists to make decisions.
Stock/purchasing records
Adverse drug reaction data
Clinical trial data
Data from hospitals
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PHARMACOECONOMICMETHODS
Economic HumanisticCost consequence
Cost benefit
Cost effectiveness
Cost minimization
Cost utility
Quality of life
Patient preferences
Patient satisfaction
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Cost effectiveness analysis [C.E.A.] -We
measure health outcomes..(Clinical units)
Health benefits are measured in natural or physical units- for
example reinfections avoided ,additional patients cured ,saved
life or life years gained
Focus on single outcome-fast decision making
Incremental cost per unit measured
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Cost minimization
analysis-
Relative comparison done on cost
basis
Comparison of a generic drug with a
branded drug
Input monetaryOutput-assumed equal
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Cost Utility Analysis
It combines both morbidity (quality of
life) and mortality (quantity of life)
QALYS(Quality Adjusted Life Years)
Input-monetary
Output-QALYS
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Cost benefit analysis
Benefits measured in terms of cost
Input and output monetary value
Results expressed-benefit to cost ratio
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Why USA is different?
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Case study-1(Scientific American Feb-2010)
Public + Private sector huge amount of resources invested
(outcomes not resourceful)
To guide spending on cancer screening National Institute of
Medicine decided to perform pharmacoeconomic evaluation.
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Group calculated that mass screening for cancer is required.
How Prevention was prevented?
Which one is more important TREATMENT/SCREENING?
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Analysis found that 19 million women in their
40s would have to be screened for 10 years.
Advocates of costs cuttings noted that those
figures could add up to $20 million (96 crore)
per life saved.
With cost benefit discussion panel had judged
the value of womens lives and decided that
that the price of saving them was too high.
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ApplicationInternational society for Pharmacoeconomics and outcomes
Research.Website-www.isopr.org
Applied Pe have been the missing link in the pharmacy
Pharmacoeconomics can be taught to postgraduates
Pe principles and methods can be applied to the real world to
enhance decision making
Pe can be applied to any therapeutic area using a variety of
application strategies
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Pharmacoeconomics consult form-
1.Id number:
2.Treatment objectives
3.Perspective
4.Type of analysis
5.Treatment options6.Cost factor (direct costs ,indirect costs)
7.Calculated results-
Method Treatment Treatment Incremental
CEA
CUA
CBA
CMA
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Conclusion-
Pharmacoeconomics is a young science (testing methods)
The science will improve with application
Clinicians must realize the importance of Pharmacoeconomics
at the macroeconomic level
Documentation guidelines by regulatory authorities important to
make evaluation more accurate and reproducible
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Questions?
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Thank you.
Thank you.