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Consensus decision models for biologics in rheumatoid and psoriatic arthritis : recommendations of a multidisciplinary working party

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Madan, Jason, Ades, Tony, Barton, Pelham , Bojke, Laura, Choy, Ernest, Helliwell, Philip, Jobanputra, Paresh , Stein, Ken, Stevens, Andrew, Tosh, Jonathan, Verstappen, Suzanne and Wailoo, Allan J. (2015) Consensus decision models for biologics in rheumatoid and psoriatic arthritis : recommendations of a multidisciplinary working party. Rheumatology and Therapy, 2 (2). pp. 113-125. doi:10.1007/s40744-015-0020-0

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Official URL: http://dx.doi.org/10.1007/s40744-015-0020-0

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Abstract

Introduction

Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies.

Methods

Our working party consisted of clinical specialists, modelers, and policy makers. Two 1-day meetings were held for members to arrive at consensus positions on model structure, assumptions, and appropriate data sources. These views were guided by clinical aspects of rheumatoid and psoriatic arthritis and the principles of evidence-based medicine. Where opinions differed, we sought to identify a research agenda that would generate the evidence needed to reach consensus.

Results

We gained consensus in four areas of model development: initial response to treatment; long-term disease progression; lifetime costs and benefits; and model structure. Consensus was also achieved on some key parameters such as choices of outcome measures, methods for extrapolation beyond trial data, and treatment switching. A research agenda to support further consensus was also identified.

Conclusion

Consensus guidance that fully reflects current evidence and clinical understanding was gained successfully. In addition, research needs have been identified. Such guidance can be updated as evidence develops and policy questions change and need not be prescriptive as long as deviations from consensus are clearly explained and justified.

Item Type: Journal Article
Subjects: ?? Arthritis ??
?? Biologics ??
?? Economic Models ??
R Medicine > RC Internal medicine
R Medicine > RS Pharmacy and materia medica
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
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Arthritis, Psoriatic arthritis, Rheumatoid arthritis, Biologicals
Journal or Publication Title: Rheumatology and Therapy
Publisher: Adis International Ltd.
ISSN: 2198-6576
Official Date: December 2015
Dates:
DateEvent
December 2015Published
25 November 2015Available
7 October 2015Submitted
Volume: 2
Number: 2
Page Range: pp. 113-125
DOI: 10.1007/s40744-015-0020-0
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: Arthritis Research UK, Medical Research Council (Great Britain) (MRC)
Related URLs:
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  • https://pubrouter.jisc.ac.uk/api/v1/noti...

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