Question
Note: This is a hypothetical situation, and the numbers you will be using with should not be taken as factual. 1. PharmaCo is advertising a
Note: This is a hypothetical situation, and the numbers you will be using with should not be taken as factual.
1. PharmaCo is advertising a drug it has recently released to the market. The drug, Aionios, has been shown to lead to a 40% reduction in the occurrence of heart attacks in men older than 50. The rate of heart attacks in this population group and in the control group during testing) was 2% per year.
Question 1: What are the absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT) for the drug?
2. Aionios has occasional side effects. In 2% of those taking the drug in clinical trials, significant hearing loss occurred. In the control group, 0.4% of those taking the placebo experienced hearing loss.
Question 2a: What is the Absolute Risk Increase (ARI) and the Number Needed to Harm (NNH) for the drug?
Question 2b: If we assign the same "cost" to the two negative outcomes (heart attack, hearing loss), is it generally worthwhile for a man in the target demographic to take Aionios?
3. The life expectancy of a 50 year old man is approximately 30 years. Since some of the patients who would receive Aionios are older than 50, assume a 20 year average life expectancy for this group. The cost of the drug is $1,000 per year, taken for the rest of the patient's life. The medical costs of having a heart attack have an expected value of $500,000. (Assume a discount rate of 0%.)
Question 3: Looking only at the financial costs, is it worthwhile for a patient in the target group to take Aionios?
4. Although every life has infinite value, the US government makes tradeoff decisions using an estimate of $10 million per life. Other actuarial valuations are based on the number of years of a person's life that are affected, at a value of $150,000 per year.
Question 4: If you also consider a potential benefit of 20 years of added life, at $150,000 per year, for those whom the drug benefits, is it worthwhile for a patient in the target group to take Aionios? (Assume a discount rate of 0%.)
5. There is a genetic screening test that indicates whether a patient would develop hearing loss as a result of taking Aionios. The test has 90% sensitivity (rate of true positives) and an 80% specificity (rate of true negatives), and 1% of the general population has this genetic variant.
Question 5: If you take the test and receive a positive test result (i.e., you have the uncommon genetic variance), what is the likelihood that you actually have the genetic trait?
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