Social and Administrative Pharmacy
What the exam tests
Social and Administrative Pharmacy tests health economics, pharmacoepidemiology, pharmacy management, and drug policy. Calculations and interpretation of study designs are common.
Core rules
- ICER = (cost of new − cost of comparator)/(effect of new − effect of comparator). The effect is usually QALYs; a negative ICER can mean dominance or can be misleading.
- NNT = 1/absolute risk reduction. If control risk is 20% and treatment risk is 12%, ARR = 8% = 0.08, NNT = 12.5, rounded to 13.
- Relative risk = risk in exposed/risk in unexposed; odds ratio compares odds, not risks. An OR overstates RR when the outcome is common.
- Adherence can be measured by proportion of days covered (PDC) or medication possession ratio (MPR); refill data show possession, not ingestion.
Worked example
A new drug costs 50,000 per patient and yields 3.0 QALYs; the comparator costs 20,000 and yields 2.2 QALYs. Incremental cost = 30,000; incremental effect = 0.8 QALY; ICER = 30,000/0.8 = 37,500 per QALY. This is the additional cost to gain one quality-adjusted life-year. It is not the average cost per QALY of either drug, and it does not by itself decide reimbursement; the threshold and budget impact matter.
Traps
Do not divide total cost by total effect; do not report NNT as a percentage; do not treat a statistically significant relative risk reduction as clinically large without the absolute effect; and do not present refill adherence as proof of ingestion.