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8/7/2019 arp[it ppt pe

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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.

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