Cost-Effectiveness Analysis in Health Care
Topic of the assignment:Perform a Cost Effectives Analysis to evaluate the use of statins for the primary prevention of coronary heart disease in men aged over 55.
- Must use a decision tree and a markov model(check essays with distinctions uploaded)
Preliminary reading: Caro J, Klittich W, McGuire A, et al. The West of Scotland coronary prevention study: economic benefit analysis of primary prevention with pravastatin. British Medical Journal 1997;315:1577-1582.
- Collet data on costs and probabilities and outcomes
- Make a model based on data to calculate effectiveness
- Summarize results robustness and interpret findings
Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW (2015). Methods for the Economic Evaluation of Health Care Programmes. Fourth edition: Oxford University Press, Oxford.
The classic textbook – a first reference to go to.
Gray A, Clarke P, Wolstenholme J, Wordsworth S (2011) Applied Methods of Cost-Effectiveness Analysis in Health Care, Oxford University Press, Oxford.
More technical and advanced textbooks, especially for statistical analysis.
Briggs A, Sculpher M, Claxton K (2006). Decision Modelling for Health Economic Evaluation. Oxford University Press, Oxford.
Excellent textbook on modelling for economic evaluation detailing state-of-the-art
READINGS FOR CREATING A MARKOV MODEL
- Briggs A. and Sculpher M. (1998) An introduction to Markov modeling for economic evaluation. Pharmacoeconomics 13(4) 397-409
- Caro J, Briggs A, Siebert U et al. Modeling Good Research Practices-Overview. A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1 Med Decis Making September–October 2012 vol. 32 no. 5 667-677 https://mdm.sagepub.com/content/32/5/667.full
QUESTIONS THE EXAMINER OF THE PAPER WILL BE LOOKING TO SEE COVERED:
- Briefly summarise the paper
What is the study about? What is the approach taken?
- Comment on the clarity of research question and data presentation;
Is the importance of this issue clear? Is it clear what question this study is trying to answer? What are the key data sources used? Can you tell where all of the data came from and how it is being used?
- Appraise the quality of costs and effects data
Did the study authors use appropriate cost figures? If not, are the limitations of these figures discussed? Where are the costs data taken from? Are the costs figures coherent with the study’s perspective?
Did the study authors use appropriate effects figures? If not, are the limitations of these figures discussed? Where are the effects data taken/elicited from (e.g. patients, experts, the general public)? Does the source/type of effects data impact the strength of findings, or introduce a bias?
- Discuss the appropriateness of the modelling techniques and sensitivity analysis
Are all treatment possibilities and outcomes considered, and if not, what are the implications of leaving out those that have not been included? Do the authors explain these modelling choices? Does the model type (e.g. Markov) appear adequate for the clinical topic being investigated? How is discounting used?
Does the study fully investigate the key parameters of the study? Around which variables is there most uncertainty? What are the implications of this uncertainty for study findings?
- Evaluate the quality of the conclusions, implications, and limitations.
Does the study discuss any methodological and data limitations? Does it overstretch the findings? Or go far enough? Is it clear what a decision-maker, clinician, or payer should do with this study’s findings? Has this study revealed new gaps in research or areas requiring further work?