Pratica di Shadowing: Cost of Illness, Budget Impact Analysis - Impara a parlare inglese con i video
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to yeah now it's recorded in progress uh
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and i will ask you to uh
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if you can uh switch off your camera uh first uh switch off your microphone too
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and i will give the word to pavel the organizer of this webinar.
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Paweł, the floor is yours.
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Thank you, Denny.
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Hello, everybody.
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Here Paweł Kowalek, Working Group 4 leader.
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I would like to welcome you to Enota's sixth webinar on pharmacoeconomics.
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The entire webinar will be recorded and will be available on the Enota YouTube channel soon.
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Today's webinar is one of a series of webinars.
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We have planned a total of 10 webinars, which we started in the beginning of this year.
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In February, we had the first one.
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And the next meetings will be held in the following months, as you can see until the end of this year.
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Each webinar will last 30 minutes with approximately 20 minutes for the presentation
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and 5 to 10 minutes for Q &A session and discussion.
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The title of today's presentation is Cost of Illness
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and Budget Impact Analysis and the lecture will be given by Dr. Medhab Cekmak -Barsbay from Ankara University, Turkey.
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Medhap is an associate professor of healthcare management at the Faculty of Health Sciences, Ankara University.
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Her research interests focus on burden of disease,
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evaluation of health policy and politics, and program assessment methods.
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She teaches health planning, comparative health systems, and health economics in several programs at her university.
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So, Madhav, please start your presentation.
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The floor is yours.
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Thank you.
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Hello everyone and thank you for attending today's session.
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Let me share my screen.
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Yes, today I'll explain to you some basic details of cost of illness analysis and budget impact analysis.
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They are two important tools of economic evaluation techniques and let me firstly explain cost of illness analysis.
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It has some relations with budget impact analysis, as you see.
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We compare current situation and new tax.
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This can be a new method,
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this can with new tech or new intervention so we could compare their costs regarding a specific illness
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and by calculating the difference these methods we will complete on budget impact analysis
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So, I'll explain some steps of cost of illness analysis.
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Firstly, we should set our purpose.
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We should start by definition.
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What should we compare?
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What should be benchmark?
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And then our perspective is really important.
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generally health system or payer perspective
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and sometimes a pharmaceutical company's perspective can be included in this analysis
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and if we want to combine all of them then the perspective is according to society,
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it combines them all.
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And then we should go with the specific disease and then we should...
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decide cost analysis approach.
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This can be incidence -based and or a prevalence -based
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and then cost analysis method we should conclude bottom -up
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or top -down method
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and then we will we should list the costs tangible intangible costs according to our perspective
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and we should collect data data and analyze
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and reports our results cost of illness analysis is related to who bears the costs
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and who enjoys the benefits so how long costs
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and outcomes are measured and what costs
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and outcomes are included these are the main questions when we are um focusing in cost of illness analysis.
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As I said earlier, study perspective is really important,
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a good starting point with determining study perspective in a really detailed way.
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It's a viewpoint from which an analysis is conducted and refers to
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which costs and benefits are included and this can be a government's perspective,
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payer perspective, even a patient's perspective and as I said if we combine the most society perspective is the most general one.
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When we In calculating costs,
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we should discriminate direct medical costs and indirect costs.
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Direct costs generally refers to the costs of diagnostic tests, drug costs, physician office visits,
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biologics and medication, surgery, hospitalization, these kinds of costs.
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And as you see here,
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the major contributors of the total health expenditure of Crohn disease were biologics at €5 ,000 and medications,
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nearly €3 ,000, followed by hospitalization, €2 ,000 euro
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and surgery it's less than hospitalization but it's very near to two thousand euro and
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we are going with the direct medical costs imported portugal the annual average cost per IBD patient is 6 ,000 euro.
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60 % is related to Crohn's disease and 40 % to ulcerative colitis.
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So direct costs are easy to calculate
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but indirect costs are not easy as direct costs
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because they include productivity losses
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and every kind of costs especially we cannot turn them into monetary units
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so indirect costs include every kind of impacts of patient and caregiver particular participation in an intervention.
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So these costs are generally much more complicated to measure than other kinds of tangible costs.
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You see a publication here exploring work productivity laws in patients with inflammatory bowel disease.
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In this article,
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it was aimed to evaluate the impact of inflammatory bowel disease on patients' professional life
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and to determine predictors of several work productivity loss.
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And when we looked at the results,
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we see absenteeism were calculated reported. And in multivariate analysis,
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these work productivity laws in these patients are analyzed and reported in results.
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And budget impact analysis is a kind of estimation,
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the financial consequences of any kind of intervention or new drugs
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and we should calculate and we should see the financial impact on annual health care use and cost for the first,
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the second and subsequent years according to our time horizon it can be one year,
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three years, five years and SPOR suggests that it can start from one year to five years.
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So according to your model, according to your time horizon,
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these estimates should exceed to five years.
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Budget impact models rely on robust estimates for market share also market share uptake of the new therapy or intervention being introduced.
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These therapies are highly costed so we should know if we can afford these kinds of drugs or interventions.
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So in terms of patients view,
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in terms of insurance perspective and healthcare policy makers and for evidence -based decision making,
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these affordability decisions are really important to pay for them or not.
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So if we are coming across with new therapies,
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every new therapist should follow with budget impact analysis to see these informed decisions.
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Budget Impact Analysis is a tool to forecast the impact and it has many approaches, many
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forecasting methods on a new intervention on payer budgets
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and takes into account the whole healthcare system in a national perspective or in a regional perspective according to your setting
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and it provides us a benchmarking for evidence -based decision making
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because if we know Although it's cost effective and it's affordable,
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we can conclude to reimburse the new drug.
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For this reason, reimbursement decisions should rely on these kinds of analysis,
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especially new drugs and new medications,
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new methods for reimbursement agencies and there are some national guidelines
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and they set all the details in these guidelines.
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Some countries like Belgium, like Netherlands, they have some specific, like Canada,
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they have budget impact analysis methods in detail,
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especially for pharmaceutical campaigns for their new drugs.
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When we are doing budget impact analysis,
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firstly, we should estimate the eligible population uptake.
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So, we should know who are suffering from this disease and the population suffering from this disease.
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And we should select the time horizon.
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It can be start from one year to five year.
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And then we should identify current and the new projected treatment mix.
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And we should benchmark and compare the two of them.
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And then we should estimate current and future drug costs and disease -related other kinds of costs like surgery,
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hospitalization, or every kind of costs.
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As I said, productivity loss costs also can be included.
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And estimating and presenting changes in annual budget impact and health outcomes.
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These are the.. the main steps of budget impact analysis.
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There are different approach in this analysis.
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The first one is epidemiology analysis.
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We should start with prevalence or incidents defining with the population like PICO questions,
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PICO's questions, what's our population?
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And we should have real time data on the share of the treated patients.
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And then we should know the healthcare resources and the related costs,
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especially associated with disease, with this disease, hospital visits, the duration of the visits,
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the duration of the hospitalization, surgery, if it should to exist or not,
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outpatient appointments, TDM tests, the count of these healthcare resources.
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And the other one is market analysis, estimating market share, it's important for pharmaceutical companies,
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it's important for new drugs.
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Also, analysis of the cost of the treatment.
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These are the four key variables.
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In any of them, we should take into consideration the cost components like unit drug costs
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or monitoring and administration of this drug that's subcutane or intravenous
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or how should we implement it possible adverse events related to these drugs and disease -related healthcare utilization,
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diagnostic, hospitalization, surgery, or outpatient visits.
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Firstly, these should be with cost effective analysis.
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They are combined.
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We distinguish the two of them from a cost -effective analysis.
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They are some common steps, common methods, some distinct features, distinct characteristics.
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And as you see a perspective and time horizon,
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we should generally use payer perspective because if we should conclude with reimbursement decisions,
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a payer perspective is it's okay.
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But so if we, for example,
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needs and many countries recommends everyone not to use only a payer perspective,
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rather society perspective, rather the especially intangible costs are really important for this reason.
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They want to include all the productivity laws or other intangible costs.
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So when we want to design the characteristic of the disease,
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what's the type, what's the situation in the society, and what's the current and new treatment,
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what's the characteristic of this disease,
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the epidemiological characteristics, and also we should know about the health system,
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the health system, especially financing measures are important,
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and scenario analysis
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um are important uh what are the existing threatened modalities in
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scenario analysis we assume uh some uh different scenarios uh some uh possible costs relate to this disease and then
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Then PICO questions, population intervention,
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comparatory outcome and settings, population is the target population,
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we should decide eligible population for treatment with the new alternative for patients suffering from this disease.
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And we should have some data sources,
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especially for epidemiologic nature of this disease.
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And market share should be determined among eligible populations and existing alternatives.
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And costing steps include all eligible costs, induction, maintenance, follow -up costs,
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and discounting and sensitivity analysis.
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Generally in budget impact analysis,
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no discounting is applied because discounting is meaningful in longer period,
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longer horizons, especially for lifelong periods.
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But we should calculate all the costs for one year or three years for this reason.
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No discounting is relevant in budget impact analysis this.
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And first the market product,
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this is one of the four variables.
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This concept is the first of its kind to enter a specific therapeutic market.
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It's relevant for a novel therapeutic class, especially important for first biologics in its indication.
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And biosimilar, that's the first challenge of branded biologic.
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And there are some approaches market share can be estimated in terms of units
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or sales and top down and bottom up approach can be applied.
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And And we should get data related to the consumption characteristics,
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and then go with the projections and forecasting.
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Initial market advantage allows for rapid uptake and higher adoption rates, especially if there's unmet need.
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In this case, health policy makers make some distinguished decisions for this initial market
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to get this initial market advantage on behalf of a pharmaceutical company.
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And we assume that the initial price benchmark is set
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and this influences cost for treated patients and comparative cost scenarios when other competitors enter the market.
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In the case of biosimilars,
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a first -to -market biosimilar can reduce costs significantly and influence the price of follow -on entrants.
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And go with the uptake patterns
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and payers may give preferential access to the first product if it addresses an unmet need or it's calculated cost -effective.
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So that cost -effective analysis will be combined with budget impact analysis.
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Early adoption patterns influence the budget forecast, especially high uptake early on,
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a higher short -term budget impact or strategic pricing or discounts can mitigate this impact.
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And there are some static or dynamic models,
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especially taking into consideration the characteristic of the population.
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They are static or the dynamic population.
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The number of patients are stable or they are reducing or increasing.
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This is the main distinction of these two models.
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And these models should combine with scenario analysis and sensitivity analysis also.
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And we get some savings with this budget impact on this and what to do with the savings.
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This is important for new therapies.
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for biosimilars to the first market significant price drops
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or reference products these kinds of savings can be used to reinvestment for new therapies and or expanding access to
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the disadvantaged patients
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This is the example of the uptake of the neodrack inhibitor versus older biologics.
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Price premium of the being first and the impact on health budget
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if it replaces costier intravenous infusion and sensitivity analysis will examine impact if a second drug enters market in year
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three and market erosion for older drugs due to first market dynamics to complete market penetration
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and adaptation speed and price setting power competitive landscape assumption overall short and medium -term budget estimates.
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So budget impact models and analysis, especially for chronic inflammatory diseases
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where innovation and highly cost new drugs first market status should be explicitly modeled as a scenario or sensitivity analysis.
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that's all thank you for attending this session if you have any questions and
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comments please feel free to ask and go with your comments
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okay thank you very much do the audience have any questions to our presenter
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i would like to start with a few questions when you when you say when you talk about the payers
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the payers are the government right right okay and uh
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and you talk about the budget impact borders uh you mentioned that the the netherlands belgium and canada have applied this uh
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BIA, so Budget Impact Analysis,
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does it reduce, what is the budget for health in this country?
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It's important for especially new drugs, new therapies.
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So if a pharmaceutical company should come to the market with a new therapy,
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with a new drug, it should, they should, the company should apply the rules of the guidelines of
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that country for implementing all the details in budget impact analysis.
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So we don't know exactly if this budget impact analysis
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or this budget impact analysis is models are efficient in uh maintaining a sort of sustainability of the healthcare system
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because in france uh the budget uh for health care system is is we have a debt
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so it was 12 or 11 billion
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in 2024 or 2023 and it has become 20 billion
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so it is increasing so we we i think we need this uh
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yeah the decision to uh to make it uh the budget sustainable
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because it it it increase dramatically so maybe we are paying too much
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or maybe the the prices are
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so too high even in france i'm not speaking about uh serbia i was uh last week in eular
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so there was a serbian rheumatologist
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and he said the price cannot cannot it is too high
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and the agency refused to provide to reimburse some projects for rare disease like it yeah for example some countries
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that are in a resource constraint situation and they tend to reimburse not the original drugs,
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the generic drugs.
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So this is the main tool and easy tool to reduce the drug -related costs in that country.
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So if we really need to access new therapy and very expensive therapy,
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What can we do for patients,
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for disadvantaged people, especially if the healthcare decision makers decided not to reimburse that drug?
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And I can tell you that the rheumatologists are thinking about this
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because it was one of the uh one of the topic
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uh the prize of the the drugs uh during the last meeting so
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does anyone would like to to ask a question to meta
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yeah yeah my comment is that new technologies very often borne budget constraints and
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it could be seen more and more often indeed okay do we have any other comments
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or questions from our audience i don't see
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so i would like to invite you for the next webinar
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which will be held in
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which will be held on 8 of July this year from 5 to 5 30 set pm
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and the speaker will be Przemysław Holko from the Jagiellonian University Medical College from Poland
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and the title of the webinar would be basics of stochastic thinking
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and mark of modeling so please register to the next webinar
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and thank you for the attending and participating this meeting
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and see you at the next webinar next month thank you
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thank you thank you bye bye have a safe day safe evening bye bye thank you you're welcome bye bye
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Vocabolario e note di pronuncia per questa lezione
Questa lezione di conversazione di livello C1 si basa sul video “Cost of Illness, Budget Impact Analysis”. Le parole che ritornano più spesso: cost, analysis, budget, impact, drug. Questo video contiene 257 frasi e 2872 parole da ripetere con lo shadowing. Il parlato dura 32:38. Chi parla lo fa lentamente, circa 88 parole al minuto, quindi c’è tempo per imitare ogni suono. Il 82% delle parole rientra nelle 3.000 più comuni dell’inglese; conviene studiare le altre prima di iniziare.
Vocaboli chiave di questo video
Le 15 parole più avanzate del video, con pronuncia e significato:
| Parola | Pronuncia | Significato |
|---|---|---|
| webinar sostantivo | /ˈwɛb.əˌnɑː/ | teleseminario, seminario in rete |
| payer sostantivo | /ˈpeɪ.ɚ/ | pagatore, pagatrice |
| calculate verbo | /ˈkælkjʊleɪt/ | calcolare |
| hospitalization sostantivo | /ˌhɑ(ː)s.pɪ.tə.lɪˈzeɪ.ʃən/ | ospedalizzazione |
| uptake sostantivo | /ˈʌpteɪk/ | assorbimento |
| characteristic sostantivo | /ˌkæɹ(ə)ktəˈɹɪstɪk/ | caratteristica |
| pharmaceutical aggettivo | /ˌfɑː.məˈs(j)uː.tɪ.kl̩/ | farmaceutico |
| reimburse verbo | /ˌɹiːɪmˈbɜː(ɹ)s/ | rimborsare |
| benchmark sostantivo | /ˈbɛn(t)ʃmɑːk/ | riferimento, termine di paragone |
| firstly avverbio | /ˈfɜɹstli/ | dapprima, prima |
| sensitivity sostantivo | /ˌsɛn.səˈtɪv.ə.ti/ | sensibilità |
| horizon sostantivo | /həˈɹaɪ.zən/ | orizzonte |
| forecast sostantivo | /ˈfɔːkɑːst/ | previsione |
| guideline sostantivo | /ˈɡaɪdˌlaɪn/ | linea guida, direttiva |
| intangible aggettivo | /ɪnˈtæn.d͡ʒə.bəl/ | intangibile |
I phrasal verb che sentirai
| Parola | Significato |
|---|---|
| switch off verbo | spegnere |
| come across verbo | dare l'impressione, avere l'aria |
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | will be recorded · will be held · is Cost |
| Present perfect have/has + participio passato — un’azione passata che conta ancora adesso | have planned · have applied · has become |
Pronuncia a cui fare attenzione
Chi parla usa 6 contrazioni e forme ridotte, come don't, I'll, I'm. Pronunciale nella forma breve, così come le senti.
- I suoni “th”: therapeutic /ˌθɛɹ.əˈpjuː.tɪk/, threaten /ˈθɹɛt.n̩/, therapist /ˈθɛɹəpɪst/
- I suoni “sh” e “zh”: hospitalization /ˌhɑ(ː)s.pɪ.tə.lɪˈzeɪ.ʃən/, benchmark /ˈbɛn(t)ʃmɑːk/, outpatient /ˈaʊtˌpeɪʃ(ə)nt/, distinguish /dɪˈstɪŋ.ɡwɪʃ/, erosion /ɪˈɹəʊʒən/
- Parole lunghe — attenzione all’accento: hospitalization /ˌhɑ(ː)s.pɪ.tə.lɪˈzeɪ.ʃən/, characteristic /ˌkæɹ(ə)ktəˈɹɪstɪk/, pharmaceutical /ˌfɑː.məˈs(j)uː.tɪ.kl̩/, sensitivity /ˌsɛn.səˈtɪv.ə.ti/, intangible /ɪnˈtæn.d͡ʒə.bəl/
I suoni difficili per chi parla italiano:
- /h/ — va soffiata, non è muta: hospitalization /ˌhɑ(ː)s.pɪ.tə.lɪˈzeɪ.ʃən/, horizon /həˈɹaɪ.zən/
- Consonante finale — senza aggiungere una vocale dopo: calculate /ˈkælkjʊleɪt/, uptake /ˈʌpteɪk/, characteristic /ˌkæɹ(ə)ktəˈɹɪstɪk/, biologic /bʌɪəˈlɒdʒɪk/, reimburse /ˌɹiːɪmˈbɜː(ɹ)s/
- /æ/ — più aperta della “e”: calculate /ˈkælkjʊleɪt/, characteristic /ˌkæɹ(ə)ktəˈɹɪstɪk/, intangible /ɪnˈtæn.d͡ʒə.bəl/, inflammatory /ɪnˈflæmət(ə)ɹi/, tangible /ˈtæn.d͡ʒə.bəl/
Come esercitarsi con questo video
- Ascolta tutto il video una volta senza parlare e annota le parole che non conosci.
- Fai shadowing frase per frase a velocità normale, ripetendo ognuna finché il tuo ritmo coincide con quello di chi parla.
- Registrati e confronta con l’originale, facendo attenzione a parole come webinar, payer, calculate.
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.