Homework 1 First: Based on the following abstract, which is a condensed summary of a research article, please answer the following questions: Abstract TITLE: Cost Analysis of Outpatient Treatment of Deep Vein Thrombosis BACKGROUND: When patients have the complication of deep vein thrombosis (DVT) after surgery, the standard anticoagulation treatment includes heparin-either intravenous unfractionated heparin (UFH) or subcutaneous low-molecular-weight heparin (LMWH) product - in combination with warfarin. After the patient's international normalized ratio (INR) is greater than 2.0 , the patient discontinues the heparin product but continues on oral warfarin for 3 to 6 months. LMWH products have been approved for outpatient use. OBJECTIVE: The objective of this study was to retrospectively measure the costs of treating patients with uncomplicated DVT discharged with either oral warfarin alone or a combination of oral warfarin and LMWH. METHODS: Medical and prescription claims for Health Plan X were assessed. Costs to the health plan for hospitalized patients discharged in 2006 with a diagnosis of uncomplicated DVT were included in the analysis, and their claims history was followed for 1 year after the initial hospital discharge date. RESULTS: Compared with patients discharged on warfarin alone, the outpatient pharmacy costs were, on average, $750 higher for the patients discharged on the LMWH and warfarin combination, but the average hospital length of stay was 2 days less, resulting in savings, on average of $2,300 in hospitalization costs. Therefore, the mean total costs to the health plan per patient were $1,550 less for patients discharged on combination therapy. One-year follow-up showed no differences in readmission rates due to DVT for the two groups of patients, indicating similar effectiveness. CONCLUSIONS: Outpatient anticoagulation therapy for uncomplicated DVT with a combination of LMWH and warfarin had higher outpatient pharmacy costs but lower hospitalization costs compared with warfarin alone, which resulted in overall savings to Health Plan X. 1. Was the title appropriate? Why or why not? 2. What was the objective of the study? Was this clear? 3. Were you able to determine the perspective? If so, what was it? 4. What type of pharmacoeconomic analysis was conducted? Why? 5. Was a sensitivity analysis conducted? If so, on what estimate(s) 5. Place a "III" in the cell that represents comparing Option III with the standard (Option If. Second: Based on the following case, please answer the following question Exercise There are three 3 -month-long options to treat students, a depression-like condition in which a student thinks he or she will be in college forever with no option for parole. Results (effectiveness) cannot be determined until students have been exposed to the treatments for a period of 3 months. Option 1 is the standard option, which consists of group counseling. Option Il consists of a new student's medication that has no side effects. Option III consists of a combination of the new medication and group counseling. The costs of the standard option, Option 1 (counseling), are $100 per month. This treatment alone is measured to be effective in 40% of the cases. The costs of Option II (medication) are $50 per month for the medication. This treatment alone is measured to be effective in 60% of the cases. The costs of Option III (counseling and medication) are the combined costs of Option I and II. The effectiveness of this combination treatment is measured to be 90%. Each option includes 3 months of therapy for these 3 month: 1. Calculate a CER for a. Option 1 b. Option II c. Option III 2. Calculate an ICER comparing Option I (the standard) with Option II. 3. Calculate an ICER comparing Option I (the standard) with Option III. 4. Place a " 11 in the cell that represents comparing Option II with the standard (Option I)
