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Are head-to-head trials of biologics needed? The role of value of information methods in arthritis research
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Welton, N. J., Madan, Jason and Ades, A. E. (2011) Are head-to-head trials of biologics needed? The role of value of information methods in arthritis research. Rheumatology, 50 (Supplement 4). iv19- iv25. doi:10.1093/rheumatology/ker242 ISSN 1462-0324.
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Official URL: https://doi.org/10.1093/rheumatology/ker242
Abstract
Reimbursement decisions are typically based on cost-effectiveness analyses. While a cost-effectiveness analysis can identify the optimum strategy, there is usually some degree of uncertainty around this decision. Sources of uncertainty include statistical sampling error in treatment efficacy measures, underlying baseline risk, utility measures and costs, as well as uncertainty in the structure of the model. The optimal strategy is therefore only optimal on average, and a decision to adopt this strategy might still be the wrong decision if all uncertainty could be eliminated. This means that there is a quantifiable expected (average) loss attaching to decisions made under uncertainty, and hence a value in collecting information to reduce that uncertainty. Value of information (VOI) analyses can be used to provide guidance on whether more research would be cost-effective, which particular model inputs (parameters) have the most bearing on decision uncertainty, and can also help with the design and sample size of further research. Here, we introduce the key concepts in VOI analyses, and highlight the inputs required to calculate it. The adoption of the new biologic treatments for RA and PsA tends to be based on placebo-controlled trials. We discuss the possible role of VOI analyses in deciding whether head-to-head comparisons of the biologic therapies should be carried out, illustrating with examples from other fields. We emphasize the need for a model of the natural history of RA and PsA, which reflects a consensus view. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
| 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 |
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| Journal or Publication Title: | Rheumatology | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 1462-0324 | ||||
| Official Date: | 4 September 2011 | ||||
| Dates: |
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| Volume: | 50 | ||||
| Number: | Supplement 4 | ||||
| Page Range: | iv19- iv25 | ||||
| DOI: | 10.1093/rheumatology/ker242 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Funder: | Arthritis Research UK |
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