Skip to main content
Erschienen in: PharmacoEconomics 5/2000

01.05.2000 | Consensus Conference Papers

Modelling in Health Economic Evaluation

What is its Place? What is its Value?

verfasst von: Mr Alan Brennan, Ron Akehurst

Erschienen in: PharmacoEconomics | Ausgabe 5/2000

Einloggen, um Zugang zu erhalten

Abstract

This paper itemises the current and developing roles of modelling in health economic evaluation and discusses its value in each role.
We begin by noting the emptiness of the dichotomy that some commentators have sought to create between modelling and controlled trials as mechanisms for informing decisions. Both are necessary parts of the armoury. Recent literature discussions are examined and the accelerating prevalence of modelling is reported.
The identified roles include: extrapolating outcomes to the longer term; adjusting for prognostic factors in trials; translating from intermediate to final outcomes; extending analysis to the relevant comparators; generalising from specific trial populations to the full target group for an intervention and to other settings and countries; systematic sensitivity analyses; and the use of modelling for the design and prioritisation of future trials.
Roles are illustrated with 20 recent examples, mostly from within our own work analysing new or contentious interventions for the Trent Development and Evaluation Committee, which is planned to be incorporated into the UK National Institute for Clinical Excellence (NICE). Each role discussed has been essential at some point in this policy-making forum.
Finally, the importance of quality assurance, critical review and validity testing is reiterated and there are some observations on processes to ensure probity and quality.
Literatur
1.
Zurück zum Zitat Canadian Co-ordinating Office for Health Technology Assessment. Guidelines for the economic evaluation of pharmaceuticals. 1st ed. Ottawa: CCOHTA, 1994 Canadian Co-ordinating Office for Health Technology Assessment. Guidelines for the economic evaluation of pharmaceuticals. 1st ed. Ottawa: CCOHTA, 1994
2.
Zurück zum Zitat Department of Health, Housing and Community Services. Guidelines for the pharmaceutical industry on preparation of submissions to the Pharmaceutical Benefits Advisory Committee. Canberra: Australian Government Publishing Service, 1995 Department of Health, Housing and Community Services. Guidelines for the pharmaceutical industry on preparation of submissions to the Pharmaceutical Benefits Advisory Committee. Canberra: Australian Government Publishing Service, 1995
3.
Zurück zum Zitat Eddy DM. Assessing medical technology. In: Eddy DM, editor. Technology assessment: the role of mathematical modelling. Washington, DC: National Academy Press, 1985: 144–75 Eddy DM. Assessing medical technology. In: Eddy DM, editor. Technology assessment: the role of mathematical modelling. Washington, DC: National Academy Press, 1985: 144–75
4.
Zurück zum Zitat Eddy D. Should we change the rules for evaluating medical technologies? In: Gelijns A, editor. Modern methods of clinical investigation. Washington, DC: National Academy Press, 1990 Eddy D. Should we change the rules for evaluating medical technologies? In: Gelijns A, editor. Modern methods of clinical investigation. Washington, DC: National Academy Press, 1990
5.
Zurück zum Zitat Rittenhouse B. Uses of models in economic evaluations of medicines and other health technologies. London: Office of Health Economics, 1996 Rittenhouse B. Uses of models in economic evaluations of medicines and other health technologies. London: Office of Health Economics, 1996
6.
Zurück zum Zitat Luce BR. Policy implications of modelling the cost-effectiveness of health care technologies. Drug Info J 1995; 29: 1469–75CrossRef Luce BR. Policy implications of modelling the cost-effectiveness of health care technologies. Drug Info J 1995; 29: 1469–75CrossRef
7.
Zurück zum Zitat Kassirer JP, Angell M. The journal’s policy on cost-effectiveness analyses [editorial]. N Engl J Med 1994; 331 (10): 669–70PubMedCrossRef Kassirer JP, Angell M. The journal’s policy on cost-effectiveness analyses [editorial]. N Engl J Med 1994; 331 (10): 669–70PubMedCrossRef
8.
Zurück zum Zitat Task Force on Principles for Economic Analysis of Health Care Technology. Economic analysis of health care technology: a report on principles. Ann Intern Med 1995; 122: 60–9 Task Force on Principles for Economic Analysis of Health Care Technology. Economic analysis of health care technology: a report on principles. Ann Intern Med 1995; 122: 60–9
9.
Zurück zum Zitat Revicki DA, Frank L. Pharmacoeconomic evaluation in the resal world: effectiveness versus efficacy studies. Pharmacoeconomics 1999: 5 (5): 423–34CrossRef Revicki DA, Frank L. Pharmacoeconomic evaluation in the resal world: effectiveness versus efficacy studies. Pharmacoeconomics 1999: 5 (5): 423–34CrossRef
10.
Zurück zum Zitat Rizzo JD, Powe NR. Methodological hurdles in conducting pharmacoeconomic analyses. Pharmacoeconomics 1999: 15 (4): 339–55PubMedCrossRef Rizzo JD, Powe NR. Methodological hurdles in conducting pharmacoeconomic analyses. Pharmacoeconomics 1999: 15 (4): 339–55PubMedCrossRef
11.
Zurück zum Zitat Sheldon TA. Problems of using modelling in the economic evaluation of health care. Health Econ 1996; 5: 1–11PubMedCrossRef Sheldon TA. Problems of using modelling in the economic evaluation of health care. Health Econ 1996; 5: 1–11PubMedCrossRef
12.
Zurück zum Zitat Buxton MJ, Drummond MF, Van Hout BA, et al. Modelling in economic evaluation: an unavoidable fact of life. Health Econ 1997; 6: 217–27PubMedCrossRef Buxton MJ, Drummond MF, Van Hout BA, et al. Modelling in economic evaluation: an unavoidable fact of life. Health Econ 1997; 6: 217–27PubMedCrossRef
13.
Zurück zum Zitat OHE Briefing. The pros and cons of modelling in economic evaluation. London: Office of Health Economics, 1997 OHE Briefing. The pros and cons of modelling in economic evaluation. London: Office of Health Economics, 1997
14.
Zurück zum Zitat Office of Health Economics. Handbook of the Office of Health Economics database of health economic evaluations. London: Office of Health Economics, 1998 Office of Health Economics. Handbook of the Office of Health Economics database of health economic evaluations. London: Office of Health Economics, 1998
15.
Zurück zum Zitat McGuire WP, Hoskins WJ, Brady MF, et al. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 1996; 334 (1): 1–6PubMedCrossRef McGuire WP, Hoskins WJ, Brady MF, et al. Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 1996; 334 (1): 1–6PubMedCrossRef
16.
Zurück zum Zitat Beard SM, Coleman R, Radford J, et al. The use of cisplatin and paclitaxel as a first line treatment in ovarian cancer. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1997 Beard SM, Coleman R, Radford J, et al. The use of cisplatin and paclitaxel as a first line treatment in ovarian cancer. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1997
17.
Zurück zum Zitat Chilcott J, Golightly P, Jefferson D, et al. The use of riluzole in the treatment of amyotrophic lateral sclerosis. Sheffield: Trent Institute for Health Services Research, 1997 Chilcott J, Golightly P, Jefferson D, et al. The use of riluzole in the treatment of amyotrophic lateral sclerosis. Sheffield: Trent Institute for Health Services Research, 1997
18.
Zurück zum Zitat Cummings C. The use of olanzapine as a first and second choice treatment in schizophrenia. Birmingham: Department of Public Health and Epidemiology, University of Birmingham, 1998 Cummings C. The use of olanzapine as a first and second choice treatment in schizophrenia. Birmingham: Department of Public Health and Epidemiology, University of Birmingham, 1998
19.
Zurück zum Zitat Beard SM, Brewin J, Packham C, et al. A review of the use of current atypical antipsychotics in the treatment of schizophrenia. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998 Beard SM, Brewin J, Packham C, et al. A review of the use of current atypical antipsychotics in the treatment of schizophrenia. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998
20.
Zurück zum Zitat US General Accounting Office. Cross-design synthesis: a new strategy for medical effectiveness research [US GAO/PEMD-92-18]. Washington, DC: US General Accounting Office, 1992 US General Accounting Office. Cross-design synthesis: a new strategy for medical effectiveness research [US GAO/PEMD-92-18]. Washington, DC: US General Accounting Office, 1992
21.
Zurück zum Zitat Drummond MF, Davies L. Economic analysis alongside clinical trials. Int J Technol Assess Health Care 1991; 7: 561–73PubMedCrossRef Drummond MF, Davies L. Economic analysis alongside clinical trials. Int J Technol Assess Health Care 1991; 7: 561–73PubMedCrossRef
22.
Zurück zum Zitat Knight C. Modelling Helicobactor pylori eradication: the HEALS model. Project report to Abbott Pharmaceutical. Sheffield: School of Health and Related Research, University of Sheffield, 1999 Knight C. Modelling Helicobactor pylori eradication: the HEALS model. Project report to Abbott Pharmaceutical. Sheffield: School of Health and Related Research, University of Sheffield, 1999
23.
Zurück zum Zitat European Society of Primary Care Gastroenterology (ESCPG). Pan-European consensus on patient management strategies for H. pylori: the management of H. pylori infection [bulletin]. ESPCG Pan-European Consensus on Patient Management Strategies for H. pylori; 1998 May 9–10; Zurich European Society of Primary Care Gastroenterology (ESCPG). Pan-European consensus on patient management strategies for H. pylori: the management of H. pylori infection [bulletin]. ESPCG Pan-European Consensus on Patient Management Strategies for H. pylori; 1998 May 9–10; Zurich
24.
Zurück zum Zitat Stevenson MD, Richards RG, Beard SM. The health economics of asthma and the role of antileukotrienes in the treatment of chronic asthma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1999 Stevenson MD, Richards RG, Beard SM. The health economics of asthma and the role of antileukotrienes in the treatment of chronic asthma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1999
25.
Zurück zum Zitat Beard SM, Ward SE, Brennan A. ScHARR Project Report to SmithKline Beecham: sensitivity analysis of the ‘ADEPT’ Depression Management Model. Sheffield: School of Health and Related Research, University of Sheffield, 1997 Beard SM, Ward SE, Brennan A. ScHARR Project Report to SmithKline Beecham: sensitivity analysis of the ‘ADEPT’ Depression Management Model. Sheffield: School of Health and Related Research, University of Sheffield, 1997
26.
Zurück zum Zitat Akehurst RL, Chilcott, JB, Holmes MW, et al. The economic implications of the use of basiliximab versus placebo for the control of acute cellular rejection in renal allograft recipients. Sheffield: School of Health and Related Research, University of Sheffield, 1999 Akehurst RL, Chilcott, JB, Holmes MW, et al. The economic implications of the use of basiliximab versus placebo for the control of acute cellular rejection in renal allograft recipients. Sheffield: School of Health and Related Research, University of Sheffield, 1999
27.
Zurück zum Zitat Pickin MD, Payne JN, Haq IU, et al. Statin therapy/HMG-CoA reductase inhibitor treatment in the prevention of coronary heart disease. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1996 Pickin MD, Payne JN, Haq IU, et al. Statin therapy/HMG-CoA reductase inhibitor treatment in the prevention of coronary heart disease. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1996
28.
Zurück zum Zitat University of York. Cholesterol and coronary heart disease: screening and treatment. Eff Health Care 1998; 4 (11): 1–16 University of York. Cholesterol and coronary heart disease: screening and treatment. Eff Health Care 1998; 4 (11): 1–16
29.
Zurück zum Zitat Chilcott JB, Brennan A. Systematic review of the use of modelling in planning and prioritising clinical trials. International Society for Technology Assessment in Health Care (ISTAHC) Conference; 1999 Jun 20–23; Edinburgh Chilcott JB, Brennan A. Systematic review of the use of modelling in planning and prioritising clinical trials. International Society for Technology Assessment in Health Care (ISTAHC) Conference; 1999 Jun 20–23; Edinburgh
30.
Zurück zum Zitat Sculpher M, Drummond M, Buxton M. The iterative use of economic evaluation as part of the process of health technology assessment. J Health Serv Res Policy 1997; 2: 26–30PubMed Sculpher M, Drummond M, Buxton M. The iterative use of economic evaluation as part of the process of health technology assessment. J Health Serv Res Policy 1997; 2: 26–30PubMed
31.
Zurück zum Zitat Fenwick E, Sculpher M, Claxton K, et al. The role of decision analytical modelling improving the efficiency and relevance of health technology assessment. York: Health Economics Study Group, 1998 Fenwick E, Sculpher M, Claxton K, et al. The role of decision analytical modelling improving the efficiency and relevance of health technology assessment. York: Health Economics Study Group, 1998
32.
Zurück zum Zitat Claxton K, Posnett J. An economic approach to clinical trial design and research priority setting. Health Econ 1996; 5 (6): 513–24PubMedCrossRef Claxton K, Posnett J. An economic approach to clinical trial design and research priority setting. Health Econ 1996; 5 (6): 513–24PubMedCrossRef
33.
Zurück zum Zitat Detsky AS. Using cost-effectiveness analysis to improve the efficiency of allocating funds to clinical trials. Stat Med 1990; 9: 173–84PubMedCrossRef Detsky AS. Using cost-effectiveness analysis to improve the efficiency of allocating funds to clinical trials. Stat Med 1990; 9: 173–84PubMedCrossRef
34.
Zurück zum Zitat Briggs A, Sculpher M, Buxton M. Uncertainty in the economic evaluation of health care technologies: the role of sensitivity analysis. Health Econ 1994; 3: 95–104PubMedCrossRef Briggs A, Sculpher M, Buxton M. Uncertainty in the economic evaluation of health care technologies: the role of sensitivity analysis. Health Econ 1994; 3: 95–104PubMedCrossRef
35.
Zurück zum Zitat Beard SM, Lorigan P, Sampson F, et al. The effectiveness of high dose chemotherapy with autologous stem cell transplantation in the treatment of Hodgkin’s disease and non-Hodgkin’s lymphoma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998. Beard SM, Lorigan P, Sampson F, et al. The effectiveness of high dose chemotherapy with autologous stem cell transplantation in the treatment of Hodgkin’s disease and non-Hodgkin’s lymphoma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998.
36.
Zurück zum Zitat Beard SM, Sampson FC, Vandenberghe E, et al. The effectiveness of high dose chemotherapy with autologous stem cell/bone marrow transplantation in the treatment of multiple myeloma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998 Beard SM, Sampson FC, Vandenberghe E, et al. The effectiveness of high dose chemotherapy with autologous stem cell/bone marrow transplantation in the treatment of multiple myeloma. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998
37.
Zurück zum Zitat Stevenson MD, Beard SM, Oakley PA, et al. Modelling of the potential impact of a regional trauma system in patients with severe head injury. Sheffield: School of Health and Related Research, University of Sheffield, 1998 Stevenson MD, Beard SM, Oakley PA, et al. Modelling of the potential impact of a regional trauma system in patients with severe head injury. Sheffield: School of Health and Related Research, University of Sheffield, 1998
39.
Zurück zum Zitat Beard SM, Holmes M, Majeed A, et al. Hepatic resection as a treatment for liver metastases in colorectal cancer. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1999 Beard SM, Holmes M, Majeed A, et al. Hepatic resection as a treatment for liver metastases in colorectal cancer. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1999
40.
Zurück zum Zitat Beard SM, Perez I, Touch S, et al. Magnetic resonance imaging (MRI) in the management of knee disorders. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998 Beard SM, Perez I, Touch S, et al. Magnetic resonance imaging (MRI) in the management of knee disorders. Sheffield: Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield, 1998
41.
Zurück zum Zitat Robinson S. Successful simulation: a practical approach to simulation projects. London: McGraw-Hill, 1994 Robinson S. Successful simulation: a practical approach to simulation projects. London: McGraw-Hill, 1994
42.
Zurück zum Zitat Robinson S, Pidd M. Provider and customer expectations of successful simulation projects. J Oper Res Soc 1998; 49: 200–9 Robinson S, Pidd M. Provider and customer expectations of successful simulation projects. J Oper Res Soc 1998; 49: 200–9
43.
Zurück zum Zitat Gass SI. OR in the real world: how things go wrong. Comput Oper Res 1991; 18 (7): 629–32CrossRef Gass SI. OR in the real world: how things go wrong. Comput Oper Res 1991; 18 (7): 629–32CrossRef
44.
Zurück zum Zitat Fossett CA, Harrison D, Weintrob H. An assessment procedure for simulation models: a case study. Operations Res Soc Am 1991; 39 (5): 710–24 Fossett CA, Harrison D, Weintrob H. An assessment procedure for simulation models: a case study. Operations Res Soc Am 1991; 39 (5): 710–24
45.
Zurück zum Zitat Finlay PN, Wilson JM. Orders of validation in mathematical modelling. J Oper Res Soc 1990; 41 (2): 103–9 Finlay PN, Wilson JM. Orders of validation in mathematical modelling. J Oper Res Soc 1990; 41 (2): 103–9
46.
Zurück zum Zitat Gass SI. Model accreditation: a rationale and process for determining a numerical rating. Eur J Oper Res 1993; 66: 250–8CrossRef Gass SI. Model accreditation: a rationale and process for determining a numerical rating. Eur J Oper Res 1993; 66: 250–8CrossRef
47.
Zurück zum Zitat Finlay PN, Forsey GJ, Wilson JM. The validation of expert systems: contrasts with traditional methods. J Oper Res Soc 1988; 39 (10): 933–8 Finlay PN, Forsey GJ, Wilson JM. The validation of expert systems: contrasts with traditional methods. J Oper Res Soc 1988; 39 (10): 933–8
48.
Zurück zum Zitat Sonnenberg FA, Roberts MS, Tsevat J, et al. Toward a peer review process for medical decision analysis models. Med Care 1994; 32 (7): JS52–64 Sonnenberg FA, Roberts MS, Tsevat J, et al. Toward a peer review process for medical decision analysis models. Med Care 1994; 32 (7): JS52–64
49.
Zurück zum Zitat Delamothe T, Smith R. Moving beyond journals: the future arrives with a crash. BMJ 1999; 318: 1637–9PubMedCrossRef Delamothe T, Smith R. Moving beyond journals: the future arrives with a crash. BMJ 1999; 318: 1637–9PubMedCrossRef
Metadaten
Titel
Modelling in Health Economic Evaluation
What is its Place? What is its Value?
verfasst von
Mr Alan Brennan
Ron Akehurst
Publikationsdatum
01.05.2000
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 5/2000
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200017050-00004

Weitere Artikel der Ausgabe 5/2000

PharmacoEconomics 5/2000 Zur Ausgabe

Adis Pharmacoeconomic Drug Evaluation

Mirtazapine