FPGEE CORE EXAMS SET 2025/2026 QUESTIONS AND
SOLUTION RATED A+
✔✔Horizontal integration - ✔✔similar entities
ndependent pharmacies > large chain pharm corps
✔✔Vertical integration; ex - ✔✔diff levels of care (e.g. hosp, medical offices, pharm)
combine into a single organization;
ex: HMO
✔✔ex of Semi-integrated models - ✔✔physicians join independent physician
associations to contract w/ HMO --> they can still see pts outside of HMO
✔✔PPOs don't focus on care efficiency/quality/cost control; T or F - ✔✔T
✔✔Pharmacy benefit managers (PBMs)
- used for ____
- may be contracted by ___
- responsible for ______
- Rely heavily on _____ - ✔✔- help decr costs of Rx drugs; incr QoC; made use of more
generic drug use
- May be contracted by managed care org, employers, private insurers health care
plans, unions, and government entities to manage prescription drug programs on behalf
of health care plan beneficiaries (i.e. patients)
- Responsible for >90% of all retail Rx drug purchases
- a drug formulary; determines which medications will be covered by the plan formulary
and may receive rebates from drug manufacturers for inclusion in the plan
- charge co-pay
✔✔list 3 lvls of service for PBMs (benefit manager) - ✔✔- Basic = claims processing
only
- Intermediate = also responsible for formulary management
- Advanced = disease state management for chronic conditions e.g. diabetes, HTN,
hyperlipid
✔✔Incidence rates - ✔✔occurrence of new cases of disease in a population at risk
during a time period
✔✔Prevalence rates - ✔✔- existing + NEW cases (diseases)
✔✔Incidence proportion - ✔✔- NEW cases of disease
✔✔Incidence rate vs. incidence proportion; incidence rate is ---> - ✔✔- denominator =
person at time at risk x yrs
,- USE incidence rate when the population at risk varies with time (e.g. population may
lose old members or add new members during the observation period)
✔✔________ rate = A snapshot of the population at a point in time and accounts ALL
the individuals with disease at the time of screening (don't care WHEN disease
developed) - ✔✔prevalence
- Can change either when new cases develop or when old cases are resolved because
some individuals are cured or have died by the time of screening
✔✔does acute or chronic diseases have higher prevalence rates and why? - ✔✔chronic
- accumulate over the yrs
✔✔Prevalence is useful for ________ diseases such as HIV and diabetes, whereas
incidence is useful for _________ diseases such as infection-related conditions
fill in the blank using: acute, chronic - ✔✔1) chronic
2) acute
✔✔Mortality rates is usually reported as # of deaths per ____ individuals per year -
✔✔1,000 individuals
✔✔mortality rate of 8 would mean 8 deaths _____ - ✔✔8 deaths in a given year per
1,000 individuals
✔✔Annual mortality rate for all causes = - ✔✔= divide the total number of deaths from
all causes in a year / by the population size as of July 1 (pop at midyr)
✔✔Specific mortality rate - ✔✔diabetes-specific mortality rate = # of deaths from
diabetic complications / number of persons in the population at midyear
✔✔Crude mortality rates do not address what - ✔✔that certain factors (like age) can
affect mortality rates
✔✔age-specific mortality rates - ✔✔several age categories > each has own mortality
rates
✔✔what is used to compare mortality rates between different populations? - ✔✔age-
adjusted mortality rates
✔✔age-adjusted mortality rates - ✔✔age-specific rates for population under
investigation
x (multiply) # in each respective age category of the standard population
, ✔✔examples of descriptive studies - ✔✔case report (single pt) or case series (# of pts)
✔✔pros & cons of case controls - ✔✔- faster
- cheaper
- good for rare diseases
- cannot use to estimate risk
✔✔Case control studies vs cohort
retro or prospective? - ✔✔- Cohort studies > Prospective; Can be retrospective if
previous data available
- Case control studies > Retrospective
✔✔Cohort studies is used when - ✔✔when rate of exposure to a RF is rare
e.g. smokers and nonsmokers can be followed through time to assess the development
of lung cancer
✔✔pros and cons of cohort studies (OR vs RR) - ✔✔- Advantages: RR offers more
powerful estimation than OR; prospective so can control cofounders and time-specific
factors
- Cons: more likely to lose subjects over long follow up period, cost
✔✔Active surveillance - 2 ways - ✔✔include only patients from a small number of
institutions
1) sentinel sites
2) registries
✔✔Sentinel sites (Active surveillance) - ✔✔are a limited number of selected reporting
sites
e.g. hosp records, NPDS (national poison data system) - collect data thru calls to US
poison control centers ---> AAPCC (American association of poison control centers)
maintains surveillance program
✔✔Sentinel events - ✔✔= cause sig harm to pts (require reporting) - death
✔✔registries examples (Active surveillance) - ✔✔- A disease registry (e.g., a cancer
registry) à list of all the patients with the disease. It can be used to estimate prevalence,
incidence, and mortality rates
- An exposure registry (e.g., a drug registry) à follow a cohort exposed to a certain RF
such as an Rx drug
✔✔Active surveillance through the REMS (a risk evaluation and mitigation strategy)
program is only required by the FDA when
1)
2)
SOLUTION RATED A+
✔✔Horizontal integration - ✔✔similar entities
ndependent pharmacies > large chain pharm corps
✔✔Vertical integration; ex - ✔✔diff levels of care (e.g. hosp, medical offices, pharm)
combine into a single organization;
ex: HMO
✔✔ex of Semi-integrated models - ✔✔physicians join independent physician
associations to contract w/ HMO --> they can still see pts outside of HMO
✔✔PPOs don't focus on care efficiency/quality/cost control; T or F - ✔✔T
✔✔Pharmacy benefit managers (PBMs)
- used for ____
- may be contracted by ___
- responsible for ______
- Rely heavily on _____ - ✔✔- help decr costs of Rx drugs; incr QoC; made use of more
generic drug use
- May be contracted by managed care org, employers, private insurers health care
plans, unions, and government entities to manage prescription drug programs on behalf
of health care plan beneficiaries (i.e. patients)
- Responsible for >90% of all retail Rx drug purchases
- a drug formulary; determines which medications will be covered by the plan formulary
and may receive rebates from drug manufacturers for inclusion in the plan
- charge co-pay
✔✔list 3 lvls of service for PBMs (benefit manager) - ✔✔- Basic = claims processing
only
- Intermediate = also responsible for formulary management
- Advanced = disease state management for chronic conditions e.g. diabetes, HTN,
hyperlipid
✔✔Incidence rates - ✔✔occurrence of new cases of disease in a population at risk
during a time period
✔✔Prevalence rates - ✔✔- existing + NEW cases (diseases)
✔✔Incidence proportion - ✔✔- NEW cases of disease
✔✔Incidence rate vs. incidence proportion; incidence rate is ---> - ✔✔- denominator =
person at time at risk x yrs
,- USE incidence rate when the population at risk varies with time (e.g. population may
lose old members or add new members during the observation period)
✔✔________ rate = A snapshot of the population at a point in time and accounts ALL
the individuals with disease at the time of screening (don't care WHEN disease
developed) - ✔✔prevalence
- Can change either when new cases develop or when old cases are resolved because
some individuals are cured or have died by the time of screening
✔✔does acute or chronic diseases have higher prevalence rates and why? - ✔✔chronic
- accumulate over the yrs
✔✔Prevalence is useful for ________ diseases such as HIV and diabetes, whereas
incidence is useful for _________ diseases such as infection-related conditions
fill in the blank using: acute, chronic - ✔✔1) chronic
2) acute
✔✔Mortality rates is usually reported as # of deaths per ____ individuals per year -
✔✔1,000 individuals
✔✔mortality rate of 8 would mean 8 deaths _____ - ✔✔8 deaths in a given year per
1,000 individuals
✔✔Annual mortality rate for all causes = - ✔✔= divide the total number of deaths from
all causes in a year / by the population size as of July 1 (pop at midyr)
✔✔Specific mortality rate - ✔✔diabetes-specific mortality rate = # of deaths from
diabetic complications / number of persons in the population at midyear
✔✔Crude mortality rates do not address what - ✔✔that certain factors (like age) can
affect mortality rates
✔✔age-specific mortality rates - ✔✔several age categories > each has own mortality
rates
✔✔what is used to compare mortality rates between different populations? - ✔✔age-
adjusted mortality rates
✔✔age-adjusted mortality rates - ✔✔age-specific rates for population under
investigation
x (multiply) # in each respective age category of the standard population
, ✔✔examples of descriptive studies - ✔✔case report (single pt) or case series (# of pts)
✔✔pros & cons of case controls - ✔✔- faster
- cheaper
- good for rare diseases
- cannot use to estimate risk
✔✔Case control studies vs cohort
retro or prospective? - ✔✔- Cohort studies > Prospective; Can be retrospective if
previous data available
- Case control studies > Retrospective
✔✔Cohort studies is used when - ✔✔when rate of exposure to a RF is rare
e.g. smokers and nonsmokers can be followed through time to assess the development
of lung cancer
✔✔pros and cons of cohort studies (OR vs RR) - ✔✔- Advantages: RR offers more
powerful estimation than OR; prospective so can control cofounders and time-specific
factors
- Cons: more likely to lose subjects over long follow up period, cost
✔✔Active surveillance - 2 ways - ✔✔include only patients from a small number of
institutions
1) sentinel sites
2) registries
✔✔Sentinel sites (Active surveillance) - ✔✔are a limited number of selected reporting
sites
e.g. hosp records, NPDS (national poison data system) - collect data thru calls to US
poison control centers ---> AAPCC (American association of poison control centers)
maintains surveillance program
✔✔Sentinel events - ✔✔= cause sig harm to pts (require reporting) - death
✔✔registries examples (Active surveillance) - ✔✔- A disease registry (e.g., a cancer
registry) à list of all the patients with the disease. It can be used to estimate prevalence,
incidence, and mortality rates
- An exposure registry (e.g., a drug registry) à follow a cohort exposed to a certain RF
such as an Rx drug
✔✔Active surveillance through the REMS (a risk evaluation and mitigation strategy)
program is only required by the FDA when
1)
2)
