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Rene J. Goldberg Arnold PharmDPresident & CEOArnold Consultancy & Technology LLC

Rene J. Goldberg Arnold PharmDISPOR

: Rene J. Goldberg ArnoldPharmD Arnold &CEO: MSc),MSc),: (MD, MSc), (PhD) : ,

Rene J. Goldberg Arnold, PharmD, iDLP3(PE)

cost-effectiveness analyses

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4cost-effectiveness analyses

utilitycost-utility analysis

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cost-effective

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intangible benefits

evidence-based medicine

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opportunity cost

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efficacyeffectivenessefficiency-11Rene J. Goldberg Arnold, PharmD, iDLP

cost-effectivenessDBP/QALY/QALY105mmHg4,85010,50095-104mmHg9,88020,400Kozma CM, Reeder CE, Schulz RM: Economic, clinical and humanistic outcome: A planning model for pharmacoeconomic research. Clin Ther 15:1121-1132, 1993.12Rene J. Goldberg Arnold, PharmD, iDLP

CE(cost-effectiveness analysis, CEA)13Rene J. Goldberg Arnold, PharmD, iDLP

cost- minimization analysis, CMAcost-consequencecost-benefit analysis, CBAcost-effectiveness analysis, CEA )cost-utility analysis, CUA)quality of life14Rene J. Goldberg Arnold, PharmD, iDLP

Utilities15Rene J. Goldberg Arnold, PharmD, iDLP

utilityquality of life, QoL1.0 0 quality-adjusted life years, QALYs16Rene J. Goldberg Arnold, PharmD, iDLP

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17/QALY

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direct medical costs direct nonmedical costs CEAindirect costsintangible costs

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Consequencesbenefits

effectiveness

utilityquality-adjusted life years , QALYs20Rene J. Goldberg Arnold, PharmD, iDLP

average cost-effectiveness=

incremental cost-effectiveness=21Rene J. Goldberg Arnold, PharmD, iDLP

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Perspective VS VS

National Health Service , NHSQALYs

VS myocardial infarction, MI23Rene J. Goldberg Arnold, PharmD, iDLP

WeinsteinStason CV 1

1Weinstein MC, Stason WB (1985). Cost-effectiveness of interventions to prevent or treat coronary heart disease. Annu Rev Public Health, 6, 41-63.

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Discounting

PV=FC DF (n, r)25Rene J. Goldberg Arnold, PharmD, iDLP

Sensitivity Analysis26Rene J. Goldberg Arnold, PharmD, iDLP

Uncertainty

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LYGQALYs30Rene J. Goldberg Arnold, PharmD, iDLP

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20066291112

Human Papillomavirus, HPV32Rene J. Goldberg Arnold, PharmD, iDLP

HPVGoldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. 16/18. J Natl Cancer Inst. 2004;96(8):60415Goldiecost-utilityHPVincidencemortalitylife expectancyincremental cost-effectiveness ratios33Rene J. Goldberg Arnold, PharmD, iDLP

-

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Arnold R. Use of interactive software in medical decision making. In:Ekins S, ed. Computer Applications in Pharmaceutical Research and Development. Hoboken: John Wiley & Sons, Inc.; 2006.Drummond M, Sculpher M, Torrance G, OBrien B, Stoddart G. Methods for the Economic Evaluation of Health Care Programmes. 3rd ed Oxford: Oxford University Press; 2007.Arnold RJ. Cost-effectiveness analysis: should it be required for drug registration and beyond? Drug Discov Today. 2007; 12(21-22):960-5.Goldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine16/18. J Natl Cancer Inst. 2004;96(8):604-15.35Rene J. Goldberg Arnold, PharmD, iDLP

Detsky AS, Laupacis A. Relevance of cost-effectiveness analysis to clinicians and policy makers. JAMA. 2007;298(2):221-224.Rascati K. Essentials of Pharmacoeconomics; Philadelphia: Lippincott Williams & Wilkins; 2008.Goldberg Arnold R. Health economic considerations in cardiovascular drug utilization. In: Frishman W, Sonnenblick E, eds. Cardiovascular Pharmacotherapeutics. 2nd ed. New York: McGraw Hill, Inc.; 2003:43.Gold MR. Cost-effectiveness in Health and Medicine; Oxford: Oxford University Press:1996.36Rene J. Goldberg Arnold, PharmD, iDLPMuennig P, Khan K. Designing and Conducting Cost Effectiveness Analysis in Medicine and Health Care; Jossey-Bass;2002.Drummond M. Economic Evaluation in Health Care: Merging Theory with Practice; Oxford: Oxford University Press ;2007.Bootman L, Townsend R, McGhan W. Principles of Pharmacoeconomics. 3rd ed. Cincinnati: Harvey Whitney Books; 2004.37Rene J. Goldberg Arnold, PharmD, iDLPChart169140300040002600041000500006500089000

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Sheet1AZT55/$69$140$3,000$4,000$26,000$41,000$50,000$65,000$89,000