Abstract:
:The past few years have seen rapid changes in the methods of decision-analytic modelling of healthcare programmes for the purposes of economic evaluation. This paper focuses on four developments in modelling that have emerged over the past few years or have become more widely used. First, no one optimal method for extrapolating outcomes from clinical trials has yet been established. Modellers may draw from a set of varied assumptions about survival extrapolation that encompass a range of possibilities from highly optimistic to extremely cautious. Secondly, the practicality and appeal of microsimulation as a method for analysing healthcare decision problems has increased dramatically with the speed of computing technology. Individual instantiations of a system are generated by using a random process to draw from probability distributions a large number of times (also known as Monte Carlo or probabilistic simulation). Microsimulation is moving in new directions, such as discrete-event simulations that simulate sequences of events by drawing directly from probability distributions of event times; this approach is now being broadly applied to model situations where populations of patients interact with healthcare delivery systems. Microsimulation modelling of transmission systems at the population level is also rapidly developing. Thirdly, model calibration is emerging as a new tool that may offer health scientists a means of generating important fundamental knowledge about disease processes. Model calibration allows evidence synthesis in which observations on observable quantities are used to draw inferences about unobservable quantities. The methodology of model calibration has advanced considerably, drawing on theories of numerical analysis and mathematical programming such as gradient methods, intelligent grid search algorithms, and many more. As a fourth issue, an area of extraordinary activity is in the use of transmission models to analyse interventions for infectious diseases, including population-wide effects of vaccination. Transmission models use differential equations to simulate, deterministically for the most part, transitions among infection-related health states. Only recently have modelling methodologies been combined so that cost-effectiveness analyses can consider explicitly not only the patient-level benefits of interventions but also the secondary benefits through transmission dynamics. Advances in technology allow more realistic and complex healthcare models to be simulated more rapidly. However, decision makers will not readily accept results from models unless they can understand them intuitively and explain them to others in relatively simple terms. The challenge for the next generation of modellers is not only to harness the power available from these newly accessible methods, but also to extract from the new generation of models the insights that will have the power to influence decision makers.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Weinstein MCdoi
10.2165/00019053-200624110-00002subject
Has Abstractpub_date
2006-01-01 00:00:00pages
1043-53issue
11eissn
1170-7690issn
1179-2027pii
24112journal_volume
24pub_type
杂志文章,评审abstract::Which costs and benefits to consider in economic evaluations of healthcare interventions remains an area of much controversy. Unrelated medical costs in life-years gained is an important cost category that is normally ignored in economic evaluations, irrespective of the perspective chosen for the analysis. National gu...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200826100-00003
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To estimate savings in the cost of caring for patients with Alzheimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship between disease progression and institutionalisation. DESIGN AND SETTING:We assessed the relation...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200017040-00005
更新日期:2000-04-01 00:00:00
abstract::Until a few years ago, griseofulvin and ketoconazole were the only 2 oral agents available for the treatment of dermatophyte onychomycosis of the toenails. With the availability of the newer antifungal agents, such as itraconazole, terbinafine and fluconazole, the armamentarium of drugs available to treat onychomycosi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813020-00007
更新日期:1998-02-01 00:00:00
abstract::The pharmaceutical industry's core business is the innovation, development and marketing of new drugs. Pharmacogenetic (PG) testing and technology has the potential to increase a drug's value in many ways. A critical issue for the industry is whether products in development should be teamed with genetic tests that cou...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624040-00004
更新日期:2006-01-01 00:00:00
abstract::Barrett's oesophagus is a premalignant complication that occurs in approximately 10% of patients with gastro-oesophageal reflux disease (GORD). In patients with Barrett's oesophagus, the risk of adenocarcinoma of the oesophagus approaches 0.5% per patient-years. Therefore, practice guidelines have been developed that ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119100-00003
更新日期:2001-01-01 00:00:00
abstract::The National Institute for Health and Care Excellence (NICE) is only one of several organisations internationally that uses economic evaluation as part of decision making regarding funding and pricing of new medical technologies. However, it can be argued that NICE has developed a more prominent international profile ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-019-00882-6
更新日期:2020-03-01 00:00:00
abstract:AIM:To assess the relative cost effectiveness of escitalopram compared with venlafaxine XR in patients with major depressive disorder (MDD). METHODS:An economic evaluation was conducted alongside a double-blind, multinational, randomised clinical trial and examined the costs and quality of life of 251 patients taking ...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200523020-00007
更新日期:2005-01-01 00:00:00
abstract::Community-acquired pneumonia (CAP) is a common diagnosis and care of CAP is responsible for significant healthcare expenditures, the majority of which are for patients who require hospitalisation. Studies have shown that significant variation exists among institutions with respect to antibacterial costs and length of ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422070-00001
更新日期:2004-01-01 00:00:00
abstract::Advanced controlled release (CR) dosage forms are relative newcomers to pharmaceutical markets, and few studies relate their efficacy, safety or compliance benefits to economic value. This literature review was undertaken to assess the cost effectiveness of CR dosage forms using such measures as purchase costs, total ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析
doi:10.2165/00019053-199405060-00005
更新日期:1994-06-01 00:00:00
abstract::Total hip arthroplasty (THA) is a major orthopaedic procedure with a high risk of postoperative thromboembolism. Increasing demand for this type of surgery, together with its high cost, has led to examination of means by which the cost of THA may be minimised. Current clinical opinion favours the use of suitable pharm...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610020-00009
更新日期:1996-08-01 00:00:00
abstract::Randomized controlled trials provide unbiased estimates of treatment effect through reducing the attribution of observed differences in outcome to the play of chance or the treatment of interest. Issues in the design of randomized trials may lead to a dilution or magnification of treatment effect when compared with cl...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200927010-00002
更新日期:2009-01-01 00:00:00
abstract:AIM:To estimate the direct and indirect costs of morbidity and mortality attributable to alcohol consumption in Germany from a societal perspective in 2002. METHODS:Using the concept of attributable risks and the prevalence-based approach, age- and gender-specific alcohol-attributable fractions for morbidity and morta...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725070-00006
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:National EQ-5D value sets are developed because preferences for health may vary in different populations. UK values are lower than US values for most of the 243 possible EQ-5D health states. Although similar protocols were used for data collection, analytic choices regarding how to model values from the coll...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11595420-000000000-00000
更新日期:2012-12-01 00:00:00
abstract::Pharmacoeconomics identifies, measures, and compares the costs and consequences of pharmaceutical products and services. The cost effectiveness of a pharmacotherapy in a particular indication depends on the molecular configuration of the drug, its safety and efficacy, and local market factors such as the acquisition ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199406040-00002
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To calculate costs for the management of deep foot infections and to identify the most important factors related to treatment costs. DESIGN:Costs for in-hospital care, surgery, investigations, antibacterials, visits to the foot-care team, orthopaedic appliances and topical treatment were calculated retrospec...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018030-00003
更新日期:2000-09-01 00:00:00
abstract::Health economic modelling studies are of interest to many parties with different responsibilities and diverging interests. Therefore, it is obvious that recognising the relevance of statistical uncertainty and dealing with it appropriately are required to obtain unbiased results from health economic modelling studies,...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422120-00001
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The reliability and validity of generic utility measures have not yet been summarized in people with multiple sclerosis (MS). It is important to assess the psychometric properties of these measures, to ensure that the values obtained by the scoring system are valid for interpretation and utilization by clinic...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0167-5
更新日期:2014-08-01 00:00:00
abstract::For practical reasons, in order to carry out economic evaluations of collective decisions, total costs will generally be compared with total benefits; hence, individuals' willingness to pay (WTP) or quality-adjusted life-years (QALYs) have to be estimated at an aggregate level. So far, aggregation has usually been don...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119040-00001
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Assessment of health state and health-related quality of life (HR-QOL) are limited by a child's age and cognitive ability. Parent-proxy reports are known to differ from children's reports. Simultaneous assessment using a parent-child dyad is an alternative approach. OBJECTIVE:Our objective was to assess the...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11597890-000000000-00000
更新日期:2012-08-01 00:00:00
abstract::The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements fo...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200220070-00002
更新日期:2002-01-01 00:00:00
abstract::A number of health-related QOL (HR-QOL) measures specifically designed for people with diabetes mellitus have appeared in the literature. This article provides a selective review of 12 measures that address this important construct. For each included study, a description of the measure and its development phase is pro...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422170-00002
更新日期:2004-01-01 00:00:00
abstract::Using the method of willingness to pay (WTP), this study assesses the value of a new antidepressant, moclobemide, relative to that of tricyclic antidepressants (TCAs), which have equivalent efficacy but less favourable adverse effect profiles. From a published meta-analysis of controlled clinical trials, we identified...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199508010-00006
更新日期:1995-07-01 00:00:00
abstract::Deterministic sensitivity analyses (DSA) remain important to interpret the effect of uncertainties in individual parameters on results of cost-effectiveness analyses. Classic DSA methodologies may lead to wrong conclusions due to a lack of or misleading information regarding marginal effects, non-linearity, likelihood...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00979-3
更新日期:2021-01-01 00:00:00
abstract::Lung cancer remains the leading cause of cancer-related death and economic burden worldwide. Despite the heavy toll of lung cancer, multiple new advances have improved patient outcomes, largely through precision medicine and targeted therapy. The associated rising economic burden however may impact the uptake of novel...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-017-0563-8
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The symptoms of attention-deficit hyperactivity disorder (ADHD) are associated with impairment in multiple domains of health-related quality of life (HR-QOL). HR-QOL of children with ADHD has been assessed by relatively long multidimensional questionnaires. A review of the literature found no studies using t...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523080-00004
更新日期:2005-01-01 00:00:00
abstract::The current US drug innovation financing framework rests on the notion that a defined period of marketing exclusivity combined with the expectation of reimbursement for clinically valuable, cost-effective therapies, followed by vigorous price competition from generic drugs and biosimilars ensures a sufficient return o...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00926-2
更新日期:2020-09-01 00:00:00
abstract::In an effort to control escalating health expenditures, especially in hospitals, many countries are planning or experimenting with prospective budgeting systems. Belgium is no exception and has recently introduced, with some success, limited fixed charges per hospital admission and/or per hospitalisation day for labor...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199609030-00006
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:Cost is an issue when prescribing two drugs with equivalent efficacy. We compared the direct medical costs of topical brinzolamide 1% (twice a day or three times daily) with topical dorzolamide 2% (twice a day or three times daily) in France, Italy, Portugal and Spain in patients with ocular hypertension or p...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200321030-00005
更新日期:2003-01-01 00:00:00
abstract::Several randomised comparative trials have shown that granulocyte colony-stimulating factor (G-CSF) reduces the duration of neutropenia, hospitalisation and intravenous antibacterial use in patients with cancer who are receiving high-dosage antineoplastic therapy. However, one area that has received less attention is ...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199711060-00005
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To explore whether the National Institute for Health and Clinical Excellence (NICE) takes account of concerns other than just incremental cost effectiveness in commissioning healthcare services. METHOD:A stated preference binary choice experiment was used to explore the preferences of members of NICE's Appra...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725080-00006
更新日期:2007-01-01 00:00:00