PRM14 Time-Dependency for Treatment Sequences in Markov Cohort Models: A Nested Markov Modeling Approach

Abstract

the threshold for a MID also increases by this factor constantly. And this leads to logarithmic function for quantifying outcomes. We examined a logarithmic functional form for MIDs in nine pairs, a combination of three health states extracted from EuroQol-5D (State A (21222), B (21122), and C (22222)) and three survival durations (10, 20, and 30 years). An online survey was conducted and 100 subjects were recruited. . One-way repeated measure analysis of variance and one-way within subjects analysis were applied. RESULTS: A total of 98 subjects completed the survey. In State A, the normalized mean of 10, 20, and 30 years were 0.63, 0.61, and 0.59, respectively. There were no significant difference in the means (p ϭ 0.1102). For State B, the normalized means were 0.66, 0.68, and 0.66 for 10, 20, and 30 years, respectively, with no significant difference among three durations (p ϭ 0.6496). Lastly, in State C, the normalized means for the starting years were 0.57, 0.55, and 0.57, respectively, and there was no statistical difference (p ϭ 0.5404). Thus, the impact of changing durations was not significant in all three states. CONCLUSIONS: Our findings implies that the MID is constant over proportional change in duration, indicating that the utility function of the MID follows a logarithmic function. This violation of the normative decision model implies treatment decisions based on the MID may not represent our preferences for health. OBJECTIVES:Budget impact analyses (BIA) are important tools for assessing financial costs associated with the implementation of health care interventions. As pressure on the limited budgets of health care systems increases, the role of BIA in the reimbursement decision-making process is set to rise. Indeed, evidence suggests that in recent years BIA conducted for new healthcare interventions have increasingly informed reimbursement decisions of payers. The aim of this study was to investigate any temporal and regional trends in the rate of study publications reporting the results of a BIA over the last ten years. METHODS: PubMed searches were performed to identify publications discussing the budget impact of treatments published for the years 2001, 2005, 2006 and 2010. For each year, the number of publications including a BIA was calculated as a proportion of all publications for that year. The search findings were examined to determine if temporal or regional trends could be observed in the publication frequency of studies reporting BIA. RESULTS: From 2001 to 2005, a 3.7-fold increase was observed in the proportion of the literature discussing BIA and from 2006 to 2010, a 3.5-fold increase was observed. When the increasing temporal trend of BIA publication was examined according to region (limited to Europe and the United States), it was noted that the trend of an increase in the rate of BIA publication was greater in Europe than in the USA. CONCLUSIONS: The period of 2001 -2011 saw an increase in the number of publications discussing BIA. This trend was more pronounced in Europe tha...