Pharmacy Health Economics and Drug Treatment Outcomes: Decision Analysis Exercise

You are interested in comparing the outcomes over a 1-year time period of preventative strategies for post-menopausal women with osteoporosis. You plan to compare three options (1) Oral Cal-More, 10 mg/day; (2) Nasal Cal-More, 200 IU/day and (3);Long-acting Cal-More, 70mg once a week. (Note: These are not real product names). The main outcome measured is incidence of bone fracture and the effect on WALYs. Each year, about 5% of the patients taking once-a-day oral Cal-More have a fracture (95% do not), about 10% of those taking nasal Cal-More experience a fracture (90% do not) and 5% of those taking long-acting Cal-More experience a fracture (95% do not). The cost of treating a fracture is $3,000anf fracture decreases a person's QALY 0.5 by QALYs. Once-a-day oral Cal-More causes nasal irritation or bleeding in 10%of the cases. Once a week oral Cal-More causes GI complication in 2% of the patients. The average cost of treating nasal problems is $100, and QaaLY's are decreased by 0.1. The cost per year of the three medications are : Once a day oral Cal-More =$600 Once a day oral Cal-More =$800 Once a day oral Cal-More =$1,000

a. Draw the decision tree.

b. Calculate the average cost for each treatment.

C. Calculate average cost QALY for each treatment.

D. Calculate the average cost per QaALY for each treatment.

E. Calculate the marginal cost per QALY between option between optio1 (oral once a day)and 2(nasal once a day)

F. Calculate the marginal cost per QALY between options 1(oral once-a-day) and 3 (oral once a week)

g. Which quadrant of the ICER plane does option 2 fall as compared to option 1.

h. Which quadrant of the ICER plane does option 3 fall as compared to option 1.