Case study H Question number 1 Answer 1 The defrence between cost-benefits and cost-effectiveness, and cost utiity analysis Cost-benefits For this we can enabe to two or more treatment aternative to be compred using the suumary metric of net monetary benefits of each treatment less the cost of each CBA is not commony used in health technoogy assessment due to difficulty of associating monetary values with health outcomes such as survival Most commony CBA have been used to assess arge capita development projects Cost effectivness The gains are typically measured in disability-adjusted life years (DALYs), representing a weighted combination of mortality and morbidity effects of an intervention. There are problems with the standardization of the tools and methods of CEA. Effectiveness data is not always derived from systematic reviews Cost-effectiveness Analysis quantifies the gains, or setbacks, in population health as a result of a particular policy or intervention. The gains are typically measured in disability-adjusted life years (DALYs), representing a weighted combination of mortality and morbidity effects of an intervention Case study H Cost-utiity anaysis Cost-utility analysis is used to determine cost in terms of utilities, especially quantity and quality of life. This type of analysis is controversial because it is difficult to put a value on health status or on an improvement in health status as perceived by different individuals or societies This allows for easy comparison across different types of health outcome, but still requires value judgements to be made about increases in the quality of life (utility) associated with different health outcomes. It therefore provides a broader context in which to make judgements about the value for money of using a particular drug. Case study H Question number 2 Answer 2 the relationship between cost-effectiveness analysis and cost-benefit analysis. Provided that a cost-effectiveness analysis includes all the relevant societal costs it is shown that a cost-effectiveness analysis can be interpreted as a cost-benefit analysis where the willingness to pay per effectiveness unit is assumed to be constant and the same for everyone It is argued that cost-effectiveness analysis is best viewed as a subset of cost-benefit analysis, where the aim of the analysis is to estimate the cost function of producing health effects. It is also concluded that to interpret and use cost-effectiveness analysis as a tool to maximize the health effects for one specified real-world budget, will be inconsistent with a societal perspective and is likely to lead to major problems of suboptimization. No its means more effectiveness then no more money Case study H Question 3 Answer 3 years 1998 types The cost effectiveness and one time oppor-tunistic screening 2002 The cost effectiveness of three intervantion of hypothetical cohort of 10000 newly diagnosed 2004 The cost effectiveness of two screeing strategies Cohorts 1= A hypothetical popu-lation without diabets assigned to either opportunistic screening or current cinical practice 2= A hypothetical cohort of 10000 newly dianosed diagnosed diabetics who are followed for the for the deveopment of major compication under the two screening aternatives 1= Intensive glycemic comtrol 2= Intensive hypertension control 3= Reduction in serum choestrol 1= Diabetes screening targeted at those individuals with hypertension 2= Universal diabetes screening That means the varius disease states associates with compication and ultimatey death The cost ignored ike that hospital charges,patient charges etc. Case study H QUESTION 4 Answer 4 Thees cost incuded in a CEA Comparator Perspective Outcomes/endpoints selected Efficacy vs. effectiveness Data capture method Direct costs Indirect costs Actual costs vs. charges/prices Marginal costs vs. average costs Time horizon of analysis Discounting Correction for inflation Modeling use Sensitivity analysis Reporting results Funding source For that categary of cost and fall is intervesting costs Case study H Question 5 Answer 5 There is a growing realization that that streaming revenue is not growing quickly enough to offset the impact of declining download sales. It is an eerily familiar echo of the recurring narrative of the noughties that download sales were not growing quickly enough to offset the impact of declining CD sales. The situation is very different now in that the industry licenses the disruptive force. Back in the noughties the combined impact of changing consumer behavior patterns, growing piracy adoption and the loss of content scarcity were factors the industry had little control over. Yet this present shift is more fundamental and will have much bigger long term impact.