Farmakoekonomi

Elly Wahyudin
Farmasi Klinik, PSPA
Pharmacoeconomics
• Health economics and pharmacoeconomics
• Peran Health economics and Pharmacoeconomics
• Economic evaluation
Health economics and Pharmacoeconomics
• Health economics applies economics to health and health care and
considers the choices concerned with allocating scarce resources.
• Pharmacoeconomics is the branch of health economics that is
specifically concerned with pharmaceutical products and services.
The Role of Health economics and
Pharmacoeconomics
Containing the rate of increase in health care spending is a principal
concern in health policy. “Cost-effectiveness” is now an important
criterion for selection therapies by providers and purchasers of health
care.
Health economics and pharmacoeconomics analyse the relationship
between the cost and consequences of health care. This analysis of
new and existing therapies is needed to inform decisions about
allocating scarce resources. The method used to analyse this
relationship is economic evaluation.
Economic Evaluation
• Economic evaluation is the comparative analysis of the costs and
consequences of two or more courses of action
• Komponen : cost dan outcomes
Costs
• Direct costs : direct medical costs
direct non-medical cost
• Indirect costs
• Intangible costs
• Costs are also divided into :
Fixed costs
Semi- fixed costs
Variable costs
Outcomes Measures
• Effectiveness
• Health related quality of life (QoL)
• Expressing benefits as monetary values
Types of Economic Evaluation
• Cost – effectiveness analysis (CEA)
• Cost – minimization analysis (CMA)
• Cost – utility analysis (CUA)
• Cost – benefit analysis (CBA)
PRINCIPAL COMPONENT ARE RESOURCES AND OUTCOMES

Process of
Inputs Outputs
Health care

Resources : Surgery Drug Outcomes :

• Buildings therapy • Effectiveness
• Staff Physiotherapy • QoL
• Drugs etc. Counseling • Utility
etc. • Monetary valuation
ANALYSIS OF COST
Total cost

Direct cost Indirect cost Intangible cost

Society’s productivity Anxiety, pain or suffering
losses due to sickness

Direct medical cost Direct non-medical cost

Patient and family out-of-pocket
expenses, other parts of public sector

Fixed cost Semi-fixed cost Variable cost

Capital and Drugs, blood products,
Staff
overheads disposable equipment
Measurements of inputs and outcomes in different forms of economic evaluations

Form of analysis Measurement Measurement of outcome Use of results

of input
Cost-effectiveness Cost Natural units (cases successfully treated, Comparison of interventions with
analysis life-years gained, disease-free time the same unit of benefit but a
different magnitude: cost per unit of
effect
Cost-minimization Cost (often only No measurement within study Cost comparison (lowest cost to
analysis direct) achive an identical result): cost per
case
Cost-utility analysis Cost Quality-adjusted life years (QALYs), Summary of multiple dimensions
healthy year equivalents (HYEs) into one scale; comparison of
treatments with initial different
outcome measures: cost per QALY
Cost-benefit analysis Cost Monetary benefit Cost minus benefit: cost-benefit rasio
Source : Kobelt 1996
 1 st drug Relapse
effective

No Relapse
DECICION-ANALYTIC
1 st drug not Relapse
1 st drug TOOL FOR
effective (due effective ANTIDEPRESSANT
to intolerance
THERAPI
of inefficacy No Relapse
1 st drug not
Patient with effective
depression
1 st drug Relapse
effective

No Relapse

TCA 1 st drug not Relapse

1 st drug
effective (due effective
to intolerance
of inefficacy No Relapse
1 st drug not
effective