Pharm Care/management Test 3 Set 2

Front 1

Markets or industry structures can be described as...(4)

Back 1

1)monopoly
2)oligopoly
3)monopolistic competition
4)perfect competition

Front 2

Monopoly def.

Back 2

one seller of a product w/ no close substitute

Front 3

Monopoly characteristics (2)

Back 3

1)high production not reqd to maximize income
2)can produce less and charge more

Front 4

Monopsony? def and (3) and ex

Back 4

one buyer

1)can set price
2)can be bad by punishing sellers
3)for Rx companies could result in decr R&D

federal govt (w/ medicare/caid)

Front 5

Oligopoly def and (3) and 3ex

Back 5

few sellers and many buyers

1)leading firm exerts price leadership
2)none benefit by price competition
3)b/w perfect competition and monopoly

1)cereal manufactures
2)some drug classes
3)utilities is classic ex

Front 6

Perfect Competition def and (5) and ex

Back 6

many sellers and buyers

1)prices set by market (not producer)
2)minimal entry barriers
3)standardized products = easy comparisons
4)consumers have complete pricing info
5)no collusion (no getting together to set prices)

Agriculture (govt subsidies can get in the way)

Front 7

Monopolistic competition def and (3) and ex

Back 7

near perfect competition

1)products not interchangeable or standardized
2)compete on product differentiation
3)minimize price competition thru differentiating their products (features)

Car industry (ex is adding features onto cars)

Front 8

How does HC fit into the market structures (9)

Back 8

1)few sellers
2)maldistribution of providers
3)entry barriers for suppliers, providers, manufacturers, pts
4)Large variations in service quality and quantity
5)almost no consumer access to price and quality info
6)Universal and insatiable demand
7)inelastic demand
8)unpredictability of demand
9)super-induced demand (control of supply and demand by specific provider)

Front 9

____ can super induce own demand

Back 9

MD's

Front 10

Insurance pt-induced demand? (3)

Back 10

1)decr out-of-pocket expenses = incr quantity demanded
2)medicare part D increased DPh shortage
3)solution is incr cost sharing (make pt pay more)

Front 11

Maldistribution of HC expenditures (2)

Back 11

1)small proportion of pts consume inordinate share of health costs
2)80/20 rule (20% of population consume 80% of HC resources)

Front 12

80/20 rule b/c of... (2)

Back 12

1)chronic diseases
2)no good prevention/management

Front 13

Discounted FFS (fee for service) effect on...
a)admissions
b)length of stay (LOS)
c)intensity of services (IOS)

Back 13

a)increase
b)increase
c)increase

Front 14

Per Diem effect on...
a)admissions
b)length of stay (LOS)
c)intensity of services (IOS)

Back 14

a)increase
b)increase
c)decrease

Front 15

Capitation effect on...
a)admissions
b)length of stay (LOS)
c)intensity of services (IOS)

Back 15

a)decrease
b)decrease
c)decrease

Front 16

DRG effect on...
a)admissions
b)length of stay (LOS)
c)intensity of services (IOS)

Back 16

a)increase
b)decrease
c)decrease

Front 17

Discounted FFS mechanism

Back 17

retrospective reimbursement based on negotiated fee schedule

Front 18

Per Diem mechanism (2)

Back 18

1)most common MCO reimbursement
2)flat rate per day (regardless of cost)

Front 19

DRG mechanism (2)

Back 19

1)flat rate TOTAL reimbursement
2)based on pt admission diagnosis

Front 20

Capitation mechanism (3)

Back 20

1)mostly used by medicaid
2)prospective reimbursement fixed per month per pt
3)regardless of actual health care utilization

Front 21

HC stratgedy of Use Market Forces mechanism (2)

Back 21

1)treat as monopoly (regulate provider fees and drug prices; is approach by many nations)
2)make pts sensitive/knowledgeable about HC costs and quality

Front 22

Academic detailing
a)def.
b)part of...

Back 22

a)go along behind drug rep and tell MD counter detailing info about what drug is more effective from a scholarly view
b)providing feedback to providers

Front 23

How to design MD and hospital reimbursement to create incentives to reduce cost... (2)

Back 23

1)contracts to control cost and inflation
2)utilization control (population effects, duration of treatment, intensity)

Front 24

Detailing?

Back 24

drug rep selling a product

Front 25

HC increases from 1993-2005 (3)

Back 25

1)per capita has doubled
2)expenditures have doubled
3)2.3% incr in % of our GDP

Front 26

Our HC system alone is....

Back 26

the 5th largest economy in the world (exceeds UK)

Front 27

2007 $____ is spent per person per year

Back 27

$7500

Front 28

HC expenditure vs. UK, Swiss, Canada, Germany (3)

Back 28

1)higher per capita
2)higher % of our GDP
3)% growth second to UK

Front 29

HC expenditures by 2016 will be...

Back 29

1/5 of our GDP

Front 30

Poor Health indicators of our HC system (things that are bad for us compared to other countries) (6)

Back 30

1)infant mortality rate (amenable to HC)
2)communicable disease mortality (HIV)
3)healthy life expectancy (DM/HTN/obesity)
4)mental HC
5)chronic diseases (under control)
6)hospitalized pts

Front 31

Rate of Spending Growth (3)

Back 31

1)growth in HC spending exceeds inflation rate (double)
2)rate of growth in HC spending exceeds rate of growth in GNP/GDP
3)spend 100% of GNP on HC eventually w/o some change

Front 32

HC spending % increase is highest...resulting in...

Back 32

in drugs made by pharmacy industry, making it a target of AARP/families USA

Front 33

Ppl pay more ____ for drugs than...

Back 33

out of pocket than other HC services EVEN w/ insurance

Front 34

Difference b/w Total US HC expenditures and US HC expenditures excluding drugs

Back 34

NOT MUCH DIFFERENCE

Front 35

National health expenditure pie (what is biggest slice)

Back 35

PRIVATE HEALTH INSURANCE

Front 36

Trend in share of total HC spending on Rx drugs

Back 36

FLAT (10.1%)

Front 37

Trends in health spending (3)

Back 37

1)0-65 are increasing
2)65+ is flat
3)85+ is decreasing

Front 38

Average # of Rx by age group
a)# in 1996 & 2002
b)WHERE WAS THE ONLY PLACE THERE WAS A DECREASE IN # from 1996 & 2002

Back 38

a)1996- 19, 2002- 25
b)0-4 (from 2.9 to 2.2)

Front 39

What accounts from most of the increase in drug spending

Back 39

increased utilitzation (using more drugs) (not so much incr in price)

Front 40

Pharmacoeconomics def

Back 40

COST AND CONSEQUENCES of drug therapy and pharmaceutical services and their impact on ppl, HC systems and society

Front 41

Outcomes Research def.

Back 41

studies that attempt to ID, measure, and eval the end results of HC services

Front 42

Pharmacoeconomics is a subet of...

Back 42

economic outcomes

Front 43

3 end results measured of outcomes research

Back 43

1)clinical
2)economic
3)humanistic effects

Front 44

Economic evaluations (5)

Back 44

1)cost of illness (COI)
2)cost minimization analysis (CMA)
3)cost benefit analysis (CBA)
4)cost effictive analysis (CEA)
5)cost utility analysis (CUA)

Front 45

Humanistic evaluations (4)

Back 45

1)QOL
2)pt preferences
3)pt satisfaction
4)WTP (willingness to pay)

Front 46

Clinical evaluations (3)

Back 46

1)experimental
2)quasi experimental
3)epidemiologic

Front 47

Types of experimental clinical eval (3)

Back 47

1)RCT
2)double blind
3)cross over

Front 48

Types of epidemologic clinical eval (3)

Back 48

1)case control
2)cohort
3)field trial

Front 49

Pharmacoeconomics has methods drawn from many disciplines (5)

Back 49

1)economics
2)epidemiology
3)medicine
4)pharmacy
5)social sciences

Front 50

Pharmacoeconomics
a)CONCEPTS introduced when and by who? (3)

Back 50

a)1978, AJHP, (McGhan, Rowland, Bootman)

Front 51

In 1979 Bootman introduced...

Back 51

that it is beneficial to do AG dosing

Front 52

Term pharmacoeconomics was introduced when and by who?

Back 52

1986, Townsend/Glaxo

Front 53

____ is linked to the success of pharmacoeconomics and outcomes research

Back 53

MTM/pharmaceutical care

Front 54

ECHO?

Back 54

economic, clinical and humanistic outcomes