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3.2.1 Introductions to Costs

A great innovation needs a solid revenue model for survival-ability. In this milestone you will be asked to use parts of the prior three capstones to generate your own market report. Identifying the innovation's market space, voice of the customer, IP and regulatory path and final path roof reimbursement are critical components for identifying whether a medical innovation should advance and be sustained commercially.

Healthcare Marketplace Capstone

Universidade de MinnesotaUniversidade de Minnesota

Curso 5 de 5 no O mercado da área da saúde Programa de cursos integrados

In the Healthcare Marketplace specialization capstone course, key skills are engendered from the four prior courses to create an original medical innovation valuation. The first course in the specialization teaches the learner to size a population or market. The second course teaches whether the clinician will or will not find value from deploying a new innovation. The third course identifies the competitive landscape of medical technology innovations to compete or complement. The fourth course, teaches how to put a monetary value on the improvement in health resulting from a new innovation. The summary of these elements creates a document of high strategic value where the learner has demonstrated not only an understanding of the marketplace but what is required for the marketplace to advance. This is what is accomplished during the Healthcare Marketplace capstone experience.

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Ministrado por

Stephen T Parente
Professor

Transcrição

This is lesson 3.2.1, Measuring Costs.

In the previous lesson, we briefly discussed an example

of thinking through a health technology assessment and the costs and

benefits involved with a treatment.

In this lesson, we'll discuss the basics of measuring costs.

First, it's important to understand why we care about costs.

Well, in an economy with limited resources that means,

the more resources that are used in producing healthcare,

the less resources we have for producing other things.

If we can identify technologies that produce the same or

better results with lower costs, it means there will be more resources to use for

other parts of the economy.

So what do we mean by cost in a CEA CBA

or CUA?

Well, the most obvious example is prices, however,

prices only exist if there's a competitive market, or

in other words, if a product is able to be bought and sold.

In a more general sense, the cost is the marginal cost,

or opportunity cost of the resource.

The way to think about this, is, the cost is the value,

of the next best use of a resource.

An example might be, time cost.

So, the time spent watching this lecture is time that can't be spent

doing something else, like watching a movie.

Costs can generally be divided into two categories.

Direct and indirect.

Direct costs are any costs that are attributable to the drug or

intervention being assessed.

For example, the drugs, any tests, supplies, the wages of healthcare

personnel and any costs attributable to medical facilities are direct costs.

As you can see, direct costs are likely to have prices.

Indirect costs are any cost that result from the use of the intervention but

are not directly attributable to the intervention.

Many indirect costs may not have prices associated with them.

Indirect cost include travel time,

any emotional effect, any caregiver time or effort.

For example, all of the time a spouse may spend providing care for

their spouse with Alzheimer's Is definitely a cost, but

it's hard to attribute a price to the time and effort spent in giving that care.

Now that we've discussed the two types of costs,

we need to consider who's costs should be measured.

There's a variety of costs that could be measured.

And this is the same as thinking about

whose perspective the technology assessment should be conducted from.

Are there patient costs we're concerned about?

Is it the hospital's costs?

The doctor's or allied health providers', insurers', government, or society's costs?

There's no one answer to this question.

Rather, the intent or

goal of the technology assessment helps to determine whose costs should be measured.

Thinking through the types of costs for each of these potential

perspectives, we may consider out-of-pocket costs or

the inconvenience of treatment if we're considering patient costs.

We may consider the cost of providing care or reimbursement amounts for

providing that care if we're considering hospitals or doctors.

From the insurer perspective the payments they make to providers and

the costs of processing claims are costs that might be incurred.

From the government perspective, the cost of paying for care, through Medicare or

Medicaid, or the cost to other government services, such as bus services,

that provide transportation, for elderly, or sick individuals.

Or productivity measures, that assess how chronic

diseases impact the amount of productivity at a state or

local or national level may be considered.

And from a societal perspective,

we may be concerned with all of these types of costs.

It's important to note,

however, that whatever perspective is used in the technology assessment,

whether it is one of these or more than one of these, we should not double count.

In the first slide of this lesson, we talked about why we measure costs or

why costs are important.

Because there's limited resources in the economy.

Another way to think about this is

what a technology assessment would look like with only benefits.

With only benefits in the technology assessment,

we could understand which outcome was better than another.

We would not be able to determine though

what resources are used to achieve that outcome?

In that sense we'd have no sense of the value of the benefits achieved.

Consider the example of a new drug to prevent heart disease

that has just been approved.

Let's consider what insurers will want to know before they cover it.

They may want to know the potential benefit.

In other words, what's the expected

patient population this drug will be used on, and how effective is it?

But they'll also want to know the costs.

If this new drug is only marginally effective, but costs hundreds of

thousands of dollars, it may not be In the insurer's best interest to cover the drug.

If on the other hand, the costs are very small,

only a few dollars per pill, but the patient population is large.

Insurers will be better off and may even save money by covering the drug because it

prevents problems from heart disease in the future.

After considering all these aspects to measuring costs,

we can next summarize measuring costs into three steps.

First, identify the types of resources to be included and

the perspective the analysis will take.

Is it from the patient's perspective, the government perspective,

the societal perspective?

And are we including indirect, or direct, or both types of costs?

Second, measure the resources that were used.

Third, place a monetary value on the resource measures.

Sum those values and identify the total cost.

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