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Εθνική Σχολή Δημόσιας Υγείας. Εισαγωγή στην Οικονομική Αξιολόγηση Dr.   Βασίλειος Φραγκουλάκης, Εθνική Σχολή Δημόσιας Υγείας Ανοικτό Πανεπιστήμιο Κύπρου Αθήνα, 2014. Potential Conflict of Interest ( last 5 years).

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Εθνική Σχολή Δημόσιας Υγείας

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Dr. ,

,2014


Potential Conflict of Interest(last 5 years)

( ) - :

  • Genesis Pharma

  • ViforPharma

  • Celgene Ltd

  • Astra eneka

  • Sanofi-Aventis

  • Amgen Hellas

  • Pfizer Hellas

  • MSD

  • NovartisHellas

  • BoehringerIngelheim

  • NovoNirdisk

  • Merck Serono Greece

  • Merck Serono NL

  • Roche Hellas

  • ()


  • ( )


.

;


,

www.youthforhumanrights.org.

Human Right #3

he right to life

Human Right #22

SocialSecurity

December 10, 1948, Universal Declaration of Human Rights, United Nations



,


,


  • / /A




Prevalence of Chronic Disease Rate Through 2030

As the baby boomers age, the number of people living with chronic conditions will grow dramatically.

Sources: 1S. Wu and A. Green, Projection of Chronic Illness Prevalence and Cost Inflation, Rand Corporation, 2000; 2G. Anderson, "Chronic Conditions: Making the Case for Ongoing Care," John Hopkins University, 2007.


Average Yearly Per Capita Health Care Spending for Persons with Chronic Diseases

Number of Chronic Conditions

Source: G. Anderson, analysis of the 2004 MEPS (prepared for PhRMA



% of population with specified chronic condition

Hypertension

(65 million people)

Diabetes

(20 million people)

Hyperlipidemia

(75 million people)

Source: PhRMA analysis of CDC, National Health and Nutrition Examination Survey 20032004.




Source: Eurobarometer Survey, Autumn 2008


:H !!

Eurobarometer Study 2008


Source: Eurobarometer Survey, Autumn 2008


Trends in health care expenditure



Less Is More!!!!

Vol. 170 No. 9, May 10, 2010

How Less Health Care Can Result in Better Health

Deborah Grady, MD, MPH; Rita F. Redberg, MD, MSc, Editor

Arch Intern Med.2010;170(9):749-750.

Author Affiliations: Department of Medicine (Dr Grady) and School of Medicine (Dr Redberg), University of California, San Francisco, and General Internal Medicine Section, San Francisco Veterans Affairs Medical Center (Dr Grady), San Francisco.

  • ntidepressants

  • Treating asymptomatic women with postmenopausal hormone therapy


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HTA: Health Technology Assessment

  • :

  • H


  • HTA





    Evidence Based Medicine

    ;

    ;

    , , ;


    Evidence based health economics

    ;

    ;

    , , ;

    +

    -


    ( )

    :

    Safety

    Efficacy

    Quality

    4. Affordability


    • (cost minimisation)

    • - (cost effectiveness)

    • - (cost utility) QALY

    • A (cost benefit)

    • (budget impact)


    Direct Costs

    Indirect Costs

    Intangible Costs



    • (Cost Minimisation Analysis)

    $AVE

    : ,


    Cost-minimization



    Cost-minimization


    O






    2. (Cost Effectiveness Analysis)

    • Is the incremental cost of treatment X, compared to treatment Y, worth the additional benefits it provides? :

      • (cost)

      • (effect)


    • HbA1c

    • Blood Pressure Reduction

    • (O )



    2. (Cost Effectiveness Analysis)

    ( )

    -

    -

    -

    -

    B

    -

    -

    B

    -

    -

    .C.E.R = ---------------------------------- = / (ICER=C/E)

    -

    2. =

    3. >CER, cost-effective


    2. (Cost Effectiveness Analysis)

    • ICER

    • :

    • ICER= C/E ICER= (3.000-2.000)/(5-4)= 1,000 LY (Life Year)

    • >CER, cost-effective


    :


    Cost Effectiveness Analysis

    +Cost

    Reject

    Reject

    Accept

    -Effect

    +Effect

    Reject

    Accept

    Accept

    -Cost


    ()?


    Source: Devlin and Parkin. Health Economics 2004; 13: 437-452.


    , .

    :

    .

    : Drummond F. Michael, 2008

    Presentation at a Forum in Athens, March 28,2008


    -

    • Cost-utility analysis (CUA):

      • CEA( )

      • :


    : , ,

    100% ?

    0% ?


    3.

    (Cost Utility Analysis)

    QALYs: quality adjusted life years,

    • T QALY health outcomes

    • (quality gains) (quantity gains)

    • QALY 0-1, 0= 1=

    • QALY , EuroQoL-5D


    -

    ICUR QALY

    :

    ICUR=(3.000-2.000)/(2,5-2.4)= 10.000 QALY


    -

    • - ( )

    • (visual analogue scale)

      • H

      • ,


    -

    • (time trade-off)

      • ( )

      • , ( ) /


    - . .


    • :

    • ) - policy-maker

    • ) spreadsheet ( guidelines)

    • ) ICER , budget holder 227


    • -

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    [email protected]


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