Question: FDA has recently approved two new drugs: Firstatin and Secondstatin. Both drugs are used to lower LDL and triglycerides. Clinical study showed that these drugs have identical side effect profiles. Firstatin costs $250 per month and Secondstatin is $200 per month. After 6 months of treatment, patients using Firstatin reported an average 130 mg/dL LDL level and patients using Secondstatin reported 110 mg/dL LDL level. The triglycerides readings were similar. Baseline LDL levels for both groups were at 160 mg/dL. Which drug is more cost-effective?

Answer Options: • A. Firstatin costs more but results in better clinical outcomes, thus is more cost-effective • B. Secondstatin dominates Firstatin. It is cheaper and more effective in reducing LDL. • C. Given different doses, the drugs cannot be compared • D. Firstatin is more cost-effective • E. Drugs have same cost-effectiveness

Answer: B

Question: TITLE: “Cost-minimization comparison of treatments with Cholestyramine and Crestor for Secondary Prevention of MI for the Third-Party Payer” Were the appropriate alternatives or comparators considered?

Answer Options: • A. No. There are many other relevant treatments for secondary prevention of MI that were not included (generic lovastatin, simvastatin, atorvastatin). • B. No. The study did not compare other types of pharmacoeconomic analyses (cost-benefit analysis, cost-effectiveness analysis and cost-utility analysis). • C. Yes. There were at least two comparisons and both were drugs that are commonly recommended by treatment guidelines. • D. Yes. There were two comparisons and each comparator represented a different class of drugs that is commonly used and clinically relevant.

Answer: A

Question: Which quadrant represents more effect and less cost?

Answer Options: • A. Quadrant I • B. Quadrant II or IV • C. Quadrant III • D. Quadrant I or III • E. Quadrant IV

Answer: E

Question: What are the strengths and weaknesses of Cost-minimization Analysis?

Answer Options: • A. It measures costs and benefits in dollar terms but it can be difficult to ascribe a dollar figure to certain outcomes. • B. It measures outcomes or effectiveness in clinical terms that are commonly used by clinicians but it is difficult to interpret the resulting ratio in purely economic terms. • C. It measures outcomes in life years that have been quality-adjusted but it is difficult to estimate the quality of an individual’s life. • D. It is simple to understand because only costs are considered but it is rarely appropriate to assume that the outcomes are equivalent. • E. None of the above.

Answer: D

Question: A pharmacoeconomic study compared cholestyramine vs. simvastatin for CAD in a 6-month real-world study. Simvastatin was better tolerated, had better compliance, reduced LDL cholesterol more, and reduced cardiovascular events. What best describes the conclusion?

Answer Options: • A. Simvastatin demonstrated better effectiveness. • B. Simvastatin demonstrated better efficacy. • C. Simvastatin demonstrated comparable efficacy to cholestyramine. • D. Cholestyramine and simvastatin are equally cost-effective. • E. Simvastatin is more cost-effective than Cholestyramine.

Answer: A

Question: FDA has recently approved two new drugs: Firstatin and Secondstatin. Both drugs are used to lower LDL and triglycerides. Clinical study showed identical side effect profiles. Firstatin costs $250/month, Secondstatin costs $300/month. After 6 months, Firstatin: 130 mg/dL LDL; Secondstatin: 110 mg/dL LDL. Baseline: 160 mg/dL. What is the best type of pharmacoeconomic study to compare these drugs?

Answer Options: • A. Cost-minimization • B. Cost-utility • C. Cost-of-illness • D. Cost-effectiveness • E. None of the above

Answer: D

Question: The city of Aurora is deciding whether to invest in improving the safety of I-225 or improving school lunches to decrease childhood diabetes. All costs and outcomes will be considered and outcomes will be measured in life-years saved. What type of pharmacoeconomic study is this?

Answer Options: • A. Cost-of-illness • B. Cost-minimization • C. Cost-effectiveness • D. Cost-utility • E. None of the above

Answer: C

Question: Which of the following should be included in a pharmacoeconomic study conducted from the insurance company or managed care company perspective?

Answer Options: • A. Lost productivity • B. Physician visits • C. Patient’s lost time for treatment (e.g., the time the patient spends getting an infusion) • D. A and C • E. B and C

Answer: B

Question: If you wanted to compare the value of these three investments—(1) physical-activity program to reduce back pain, (2) screening/awareness program to reduce depression morbidity, (3) obesity prevention program for a city—what type of pharmacoeconomic study would allow comparison?

Answer Options: • A. Cost-minimization analysis • B. Cost-benefit analysis • C. Cost-utility analysis • D. B or C • E. None of the above

Answer: D

Question: FDA has recently approved two new drugs, Firstatin and Secondstatin. Both are used to lower LDL and triglycerides and have very similar efficacy and identical side-effect profiles. What is the best type of pharmacoeconomic study to compare these drugs?

Answer Options: • A. Cost-minimization • B. Cost-utility • C. Cost-of-illness • D. Cost-effectiveness • E. None of the above

Answer: A