farmakoekonomi1

8/10/2019 FARMAKOEKONOMI1

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FARMAKOEKONOMI

VITIS VINI FERA R.U


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Komposisi nilai:

30 % tugas terstruktur

30 % ujian mid30 % ujian akhir

10keaktifan?

Bobot nilai: A: 80,00; B: 66,00-79,99;C: 56,00-65,99; D: 46,00-55,99; E: 46,00

Kontrak Pembelajaran


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Materi Perkuliahan dan Tugas

Kompetensi Mata Kuliah: Mahasiswa mampu menjelaskananalisis farmakoekonomi untuk membandingkan pelayanankesehatan yang paling efektif

Pendahuluan: Pentingnya mata kuliah farmakoekonomi,

Prinsip Dasar Farmakoekonomi Analisis Farmakoekonomi (cost minimization analysis/CMA,

cost effectiveness analysis/CEA, cost utility analysisi/CUA, costbenefit analysis/CBA)

Pengukuran Kualitas Hidup Dalam Evaluasi Obat

Analisis Keputusan dan Evaluasi Farmakoekonomi

Studi Kasus


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Pendahuluan

Apoteker Sebagai Bagian Dari Sistem Pelayanan Kesehatan

DOKTER

PASIEN

PERAWAT

AHLI GIZIAPOTEKER

PROFESIONAL

LAINNYA

PELAYANAN

MEDIS

ASUHANKEPERAWATAN

PELAYANAN

GIZI

PELAYANAN

FARMASI

PELAYANANKESEHATAN

LAINNYA

KONTAK

PROFESIONAL


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HEALTH

CARE

OUTCOME

HUMANISTICCLINICAL ECONOMIC


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Economics: science of scarcity and choice

RESOURCES CHOICES

NEEDS

WANTS

PRIORITY

SUPPLY

DEMANDS

we want to make the

best use of them.


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If you have only 15,000 Rp.

You have choices of lunch,

either or

How do you make decision?

7


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As a pharmacist at community

pharmacy

There is a child getting sick with URI upper respiratory infection.

There are choices of

or

How do you select?

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What you may concern.

Does it work (symptom vs efficacy)?

What is side effect?

What would the patient feel (taste, compliance)?

How much does it cost (concerning on patients

economic status/ affordability)?

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Your Job : As a hospital pharmacist,you have to provide evidence

for hospital administrative board

to incorporate COX-2 for osteoarthritisinto hospital formulary.

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11

Factor NSAID COX-2

Efficacy higher lower

Side effect

- gastrointestinal lower higher

- cardiovascular lower higher

Drug cost/ 3 months lower higher

Factor NSAID COX-2

Efficacy lower higher

Side effect

- gastrointestinal higher lower

- cardiovascular higher lower

Drug cost/ 3 months higher lower

IF; scenario A. Which one do you select?

IF; scenario B. Which one do you select?


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Factor NSAID COX-2

Efficacy

lower

higher

Side effect

- gastrointestinal higher lower

- cardiovascular higher/ lower lower/ higher

Drug cost/ 3 months

lower

higher

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Preliminary review

Which one is better? NSAID or COX-2

Which one is cheaper? NSAID or COX-2

Which one will you select? NSAID or COX-2


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In sum

We have limited money/ resources.

We have choices of how to use the money.

When we use money for one choice, we lose

opportunity to use for another choice.

We have to make decision on choosing for a moreworthwhile of money used.

Outcomes of choices are multiple ones. We need a method to combine outcomes before

comparing between the choices.

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Economic Burden

to the Society

Obat Yang Rasional: Safe, Effective,Acceptable PENINGKATAN

KESEJAHTERAAN PASIEN

ACCESSIBLE

DISEASE BURDEN


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Reeder CE. Overview of pharmacoeconomics and pharmaceutical outcomes

evaluations. Am. J. Health Syst. Pharm. 1995;52(suppl_4):S5-8.

Pharmacoeconomics:

Pharmacoeconomics may be defined as balancing the

costwith the consequences (outcomes) ofpharmaceutical therapies and services.

As a type of outcomes evaluation, pharmacoeconomics

looks beyond just the direct cost of a pharmaceutical by

including its impact on total health resource utilizationand costs.


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Health economics is a discipline that analyses

the economic aspects of health and healthcareand that usually focuses on the costs

(inputs) and the consequences (outcomes) of

health care interventions using methods and

theories from economics and medicine.

Berger et al 2003.

Economic evaluation is the comparative

analysis of alternative courses of action in

terms of both their costs and consequences.

Drummond et al 2005.

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EE_TP_theory.pptx


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Why study Pharmacoeconomics?

Health Expenditures as a % of GDP by Country

0.02.0

4.0

6.0

8.0

10.0

12.014.0

16.0

18.0

1970

1975

1980

1985

1990

1995

2000

2005

Year

%G

DP

Canada

France

Germany

Japan

United Kingdom

United States


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But when it comes to outcomes

Life Expectancy at Birth by Country

60

63

66

69

72

75

78

81

84

1961

1966

1971

1976

1981

1986

1991

1996

2001

2004

YEAR

YearsofLife CanadaFrance

Germany

Japan

UK

US


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So

What are we doing wrong?

And how can we improve ourperformance?

by spending less

getting better outcomes


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Pharmacoeconomics allows us

to compare the economic resources consumed

(inputs) to produce the health and economic

consequences of products or services

(outcomes).

INPUTS OUTCOMES

Economic Health and EconomicResources Consequences


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Patient

Outcomes

Clinical

Economic

HumanisticPathogens

Socio-economic factors

Technology

Healthcare facilities

Health financing

Outcomes in health care (ECHO model)

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Outcomesof Health Care

Clinical outcomes;mortality, morbidity, disability, clinical end points e.g.

blood pressure, serum glucose concentrations.

Humanistic outcomes;

effects on physical, social, and emotional well-being e.g.

patient satisfaction, QALYs (Quality-adjusted life years).

Economic outcomes;

impact on total health resource utilization and cost e.g.savings (change) on treatment cost due to clinical

pharmacy services.

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Economic evaluation (EE)

The comparative analysis of alternative

courses of action in terms of both their costs

and consequences.

Choice

Program A

Program B

Consequences A

Consequences B

Cost A

Cost B

EE_TP_theory.pptx


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25

25

Principles of EE

CostsoftheoptionEffectivenessoftheoption

Lower

Higher

LowerHigher

EE

EE(rare case)

Accept

Reject

EE_TP_theory.pptx


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2. Identify the perspective

that is, who will be utilizing the information to

make whatdecisions.

This will guide you in choosing the relevant

costs and benefits.


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Perspectives

1. Patient

2. Health Practitioner

3. Hospitals or Hospital systems

4. Third-Party payers

5. Societal


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Patient Perspective

Examples of costs that directly affectthe patient include:

Out-of-Pocket costs

lost income transportation

Relevant Consequences are: Therapeutic effectiveness Adverse events Quality of Life (QOL)


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Health Practitioner

Costs to physicians may include:

Hospitalization

Pharmacy

Personnel

Supplies

Consequences of interest are:

Therapeutic effectiveness

Adverse events


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Hospitals

Costs include:

Hospital stay costs

Treatment of adverse events & complications

Consequences of interest:

Therapeutic effectiveness

Adverse events


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Third-Party Payer

Costs of care incurred for covered serviceswhich may include:

Hospitalization

Pharmacy

Nursing home care

Consequences of interest None


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Societal

All possible costs including lost productivity

All possible consequences including QoL, & lifeyears.


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Cost factors are becoming more

important

From whose perspective?

Health provider?

Patient?

Societal (masyarakat)?

Payer?


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Biaya (cost) didefinisikan sebagai besarnya

sumber daya (resources) yang dikonsumsi

Biaya produk atau pelayanan merupakan nilai

moneter dari sumber daya yang dikonsumsi

dalam menghasilkan barang atau jasa

Sumber daya antara lain: sdm, sarana prasarana,

gedung


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Macam-macam biaya

Biaya Langsung (Direct Cost)

Biaya Tak Langsung (Indirect Cost)

Biaya Tak Teraba (Intangible Cost)

Biaya Tetap (Fixed Cost) Biaya Tidak Tetap (Variable Cost)

Biaya rata-rata (Average Cost)

Biaya marjinal (Marginal Cost)

Cost of illness Cost of therapy


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Quote of the day

adai membuat pohon memiliki

akar yang lebih dalam dan kuat

(Dolly Parton, Singer, Amerika)

farmakoekonomi1

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