A Decision Chart for Assessing and Improving the Transferability of Economic Evaluation Results Between Countries

Welte, R; Feenstra, Talitha; Jager, Hans; Leidl, Reiner

doi:10.2165/00019053-200422130-00004

Cited by 229 publications

(226 citation statements)

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“…discount rates); and inputs measuring prevalence or the costs of smoking‐attributable diseases. Although this categorization is generally consistent with previous studies 28, our empirical evidence‐based shortlist can provide potential modellers with even more specific direction as to what input to choose from each of the listed categories above. This is a major contribution to the empirical literature concerning transferability of economic evidence.…”

Section: Discussionsupporting

confidence: 78%

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A utility of model input uncertainty analysis in transferring tobacco control‐related economic evidence to countries with scarce resources: results from the EQUIPT study

Németh¹,

Kulchaitanaroaj

Lester‐George

et al. 2018

Addiction

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AimsTo inform the transferability of tobacco control‐related economic evidence to resource‐poor countries.MethodsWe ran a univariate sensitivity analysis on a return on investment (ROI) model, the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), to identify key input values to which the ROI estimates were sensitive. The EQUIPTMOD used a Markov‐based state transition model to estimate the ROI of several tobacco control interventions in five European countries (England, Germany, Spain, Hungary and the Netherlands). Base case ROI estimates were obtained through average values of model inputs (throughout the five countries), which were then replaced one at a time with country‐specific values. Tornado diagrams were used to evaluate the significance of sensitivity, defined as a ≥ 10% difference in ROI estimates from the base case estimates.ResultsThe ROI estimates were sensitive to 18 (of 46) input values. Examples of model inputs to which ROI estimates were sensitive included: smoking rate, costs of smoking‐related diseases (e.g. lung cancer) and general population attributes.ConclusionCountries that have limited research time and other resources can adapt EQUIPTMOD to their own settings by choosing to collect data on a small number of model inputs. EQUIPTMOD can therefore facilitate transfer of tobacco control related economic evidence to new jurisdictions.

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Section: Discussionsupporting

confidence: 78%

“…Welte et al . 28 also stated that a multivariate or probabilistic sensitivity analysis can be a promising way to quantify the uncertainty associated with the transfer of the results of economic evaluations. However, for a model as large and sophisticated as EQUIPTMOD, pragmatism must be weighed against aspiration.…”

Section: Discussionmentioning

confidence: 99%

A utility of model input uncertainty analysis in transferring tobacco control‐related economic evidence to countries with scarce resources: results from the EQUIPT study

Németh¹,

Kulchaitanaroaj

Lester‐George

et al. 2018

Addiction

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“…By performing sensitivity analysis on the model the user is provided with additional understanding of the limitations of the model, while information about the uncertainty of the model parameters is obtained by observing the impact of changes in model parameters. Also, the ability to perform sensitivity and scenario analysis on all relevant model parameters facilitates the assessment of international transferability and may help adaptation of the study design to other geographical areas if desired [39]. Users can study the model behavior in more detail, test its robustness and adapt the model to their local conditions to assess its validity.…”

Section: Web Interfacementioning

confidence: 99%

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Hubben

Bos

Glynn³

et al. 2007

Vaccine

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Enhanced decision support for policy makers using a web interface to health-economic models -Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands Hubben, G.A.A.; Bos, J.M.; Glynn, D.M.; op 't Ende, Anna; van Alphen, L.; Postma, Maarten Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. AbstractWe have developed a web-based user-interface (web interface) to enhance the usefulness of health-economic evaluations to support decision making (http://pcv.healtheconomics.nl). It allows the user to interact with a health-economic model to evaluate predefined and customized scenarios and perform sensitivity analysis. To explore its usefulness, it was applied to an evaluation of cost-effectiveness of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine (PCV7), that was used to support a policy decision on the inclusion of PCV7 in the national vaccination program (NVP) of the Netherlands. We used a decision-tree analytic model to project the impact of infant vaccination with four doses of PCV7 on an annual cohort of infants born in the Netherlands. The base-case analysis includes the beneficial effects on unvaccinated individuals (herd protection). Additional scenarios varying the number of doses, discount rate for effects and the number of serotypes in the vaccine were evaluated and can be analysed on the web. Our model projects a base-case incremental cost-effectiveness ratio (iCER) of D 14,000 (95% uncertainty interval (UI): 9,800-20,200) per quality adjusted life year (QALY) or D 15,600 (95% UI: 11,100-23,900) per life year gained (LYG).

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“…The extent to which the study is applicable (or transferrable) to the question of interest depends on a number of potential factors (24)(25)(26)(27). Currently, neither consensus nor instrument is available to rate the impact of on the transferability of results.…”

Section: Transferabilitymentioning

confidence: 99%

A methodological framework of preparing economic evidence for selection of medicines in the Chinese setting

Sun

Faunce

2010

J Evidence Based Medicine

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Medicines are becoming a major component of health expenditure in China. Selection of effective and cost-effective medicines represents an important effort to improve medicines use. A guideline on cost-effectiveness studies has been available in China. This guideline, however, fails to be a practical tool to prepare and critically appraise economic evidence. This article discusses, in the Chinese context, the approach to integrating economic component into the medicines selection, and elaborates the methods of producing economic evidence, including conducing economic reviews and primary economic studies.Medicines are an increasingly significant component of health expenditure in China. The medicines expenditure of hospitalized patients, for example, usually accounts for around 45% of their total medical bill (1). Rapid increases in price are rendering medicines unaffordable to many Chinese patients. The demand for more efficient, quality use of medicines has become increasingly strident, and the implementation of an Essential Medicines List in patient care represents one of the efforts to improve medicines use.Selection of effective and cost-effective medicines is the key to implementing an efficient Essential Medicines List. In the last decade, extensive methodological work has been undertaken in China to improve the assessment of effectiveness of medicines (2, 3). However, little was done to explore best approaches to addressing cost-effectiveness. Despite increasing publication of cost-effectiveness studies in the Chinese medical literature (4, 5). the methodological quality varies substantially.In an effort to improve the conduct of cost-effectiveness studies, China has developed a guideline on economic evaluation of medicines (6). This endeavor-which follows a stream of similar attempts in other countries (7-11)-offers methodological standards of conducting economic studies. However, it fails to provide policy makers and researchers with practical tools for preparing and using economic evidence for selection of medicines. This article offers a methodological framework to address issues about economic evidence in the context of medicines selection for a Chinese Essential Medicines List. Integrating economic evidence into the selection of medicinesIntegrating economic evidence in the process of medicines selection for an Essential Medicines List typically starts with formulation of a focused economic question that reflects policy maker's perspective. It is followed with a systematic review of existing studies that assesses the strength of economic evidence. The subsequent decisions will then be made on the basis of strength of economic evidence, which can be categorized into three levels.r Strong evidence without uncertainty. The existing evidence provides precise and unbiased estimates of comparative cost effectiveness, and the study settings-including patients, interventions, outcomes, and clinical practice patterns-are applicable to the question being evaluated. In such case, a decision about accep...

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A Decision Chart for Assessing and Improving the Transferability of Economic Evaluation Results Between Countries

Cited by 229 publications

References 10 publications

A utility of model input uncertainty analysis in transferring tobacco control‐related economic evidence to countries with scarce resources: results from the EQUIPT study

A utility of model input uncertainty analysis in transferring tobacco control‐related economic evidence to countries with scarce resources: results from the EQUIPT study

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

A methodological framework of preparing economic evidence for selection of medicines in the Chinese setting

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