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An overview of models used in economic analyses of biologic therapies for arthritis-from current diversity to future consensus

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Madan, Jason, Ades, A. E. and Welton, N. J. (2011) An overview of models used in economic analyses of biologic therapies for arthritis-from current diversity to future consensus. Rheumatology, 50 (Supplement 4). iv10- iv18. doi:10.1093/rheumatology/ker240

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Official URL: https://doi.org/10.1093/rheumatology/ker240

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Abstract

A number of cost-effectiveness models have been developed with the aim of providing guidance for decision making on biologic therapies for the management of inflammatory joint disease. The findings of these analyses can differ markedly, and these differences can undermine the credibility of such models if unexplained. To allow differences between models to be identified more easily, we define six components common to all models-initial response, longer term disease progression, mortality, quality-adjusted life year estimation, resource use and the selection and interpretation of data. We give examples of divergent approaches taken by model structures to the same issue, and explore the impact of divergence on model results, with particular focus on two models that have reported substantially different estimates for the cost-effectiveness of third-line etanercept vs conventional DMARD. The sensitivity of results to a particular assumption made in a model will depend on the decision problem and assumptions made elsewhere in the model, highlighting the importance of guidance throughout model development. To some extent, guidance from bodies such as the National Institute of Health and Clinical Excellence can be used to determine which approach should be preferred where models differ. However, there is a pressing need for clinical input and guidance before consensus can be reached on the most credible model(s) to use for decision support.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Rheumatology
Publisher: Oxford University Press
ISSN: 1462-0324
Official Date: September 2011
Dates:
DateEvent
September 2011Published
7 June 2011Accepted
Volume: 50
Number: Supplement 4
Page Range: iv10- iv18
DOI: 10.1093/rheumatology/ker240
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: Arthritis Research UK
Open Access Version:
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