Economic Evaluation Critical Appraisal: HIV/AIDS Pre-Exposure Prophylaxis Study in Men Who Have Sex

Complete All the following 12 short-answer questions (26 marks total). Total word count: 700 words.

1. How does implicit rationing differ from explicit rationing?  Please give an example.(2 mark)
   
   
2. Outline two methods of explicit rationing.(2 marks)
   
   
3. What is sensitivity analysis, why is it important and what form can it take?  Please support your answer with evidence.(2 marks)
   
   
4. What are quality-adjusted life years (QALYs) and critically discuss 2 problems that may arise from their use.(3 marks).

5. List two major factors affecting medical care demand for a typical individual.(2 marks).

6. There are two treatments for HIV/AIDS. Drug A will cost 5,000,000 $ Dollars, and it is estimated that it will increases life years by 20 years. Drug B will cost 1,500,000 $ Dollars and it is estimated that it will increase life years by 10 years. Please show your workings for your Incremental Cost Effectiveness ratio and interpret your answer.(2 marks)
   
   
7. Name two factors that can impact on cost effectiveness thresholds.(2 marks).  

8. What is horizontal inequity in relation to healthcare financing and name one factor that can contribute to it in relation to health care financing systems.(2 marks)

9. Explain physician-induced demand and two reasons why it can occur?(3 marks)

10. The Grossman model of health is a model predicting that people consume more medical care if they have a taste for health care. Is this statement true or false – please explain why?(2 marks)

11. The market value of a resource may not be an adequate reflection of opportunity cost. Explain what this means with an example.(2 marks).

12. Give 4 examples of health care resources.  (2 marks).  

Complete TWO out of the three longer-answer questions. Responses should be around 400 words in length. (24 marks total). Please leave the third option which you do not answer BLANK. Total word count: 800 words.

Please note that the word count for the economic evaluation critical appraisal does not include the question headings for each question – it only includes what you have written in response.

1. When prioritising health care, the aim is to achieve efficiency (maximising health benefits given limited resources) whilst not compromising equity (fair distribution of resources). Critically discuss how efficiency is related to equity   in more depth with examples.(12 marks)

2. Why is scarcity an issue for health systems and how does rationing impact on scarcity? Please give at least 2 examples.(12 marks)

3. Healthcare purchasers are involved in the planning and commissioning of local healthcare services.  What factors need to be taken into account in planning and commissioning local healthcare services so as to maximise health gain in the context of finite resources.(12 marks)

Economic Evaluation (1500 words) (50 marks). Please note that the word count for the economic evaluation critical appraisal does not include the question headings for each question – it only includes what you have written in response.

Using the Drummond Criteria critically appraise the following economic evaluation which was published in the Lancet on HIV/AIDS. (1500 words) (50 marks).

Full reference for the article above is:

Cambiano, V. et al. (2018) Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation.  Lancet Infect Dis 18: 85–94