The Application and Implications of Novel Deterministic Sensitivity Analysis Methods.

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 and correlations. In addition, tornado diagrams are misleading in some situations. Recent advances in DSA methods have the potential to provide decision makers with more reliable information regarding the effects of uncertainties in individual parameters. This practical application discusses advances to classic DSA methods and their implications. Three methods are discussed: stepwise DSA, distributional DSA and probabilistic DSA. For each method, the technical specifications, options for presenting results, and its implications for decision making are discussed. Options for visualizing DSA results in incremental cost-effectiveness ratios and in incremental net benefits are presented. The use of stepwise DSA increases interpretability of marginal effects and non-linearities in the model, which is especially relevant when arbitrary ranges are implemented. Using the probability distribution of each parameter in distributional DSA provides insight on the likelihood of model outcomes while probabilistic DSA also includes the effects of correlations between parameters.Probabilistic DSA, preferably expressed in incremental net benefit, is the most appropriate method for providing insight on the effect of uncertainty in individual parameters on the estimate of cost effectiveness. However, the opportunities provided by probabilistic DSA may not always be needed for decision making. Other DSA methods, in particular distributional DSA, can sometimes be sufficient depending on model features. Decision makers must determine to which extent they will accept and implement these new and improved DSA methodologies and adjust guidelines accordingly.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Vreman RA,Geenen JW,Knies S,Mantel-Teeuwisse AK,Leufkens HGM,Goettsch WG

doi

10.1007/s40273-020-00979-3

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

1-17

issue

1

eissn

1170-7690

issn

1179-2027

pii

10.1007/s40273-020-00979-3

journal_volume

39

pub_type

杂志文章
  • Reform of prescription drug reimbursement and pricing in the German social health insurance market: a comparison of three scenarios.

    abstract::We review regulation of two important parameters for third-party payers and manufacturers of prescription drugs: regulation of reimbursement and pricing. We find that centralised regulation of reimbursement and pricing prevails in the 15 original EU member countries (EU-15) and in European Free Trade Association (EFTA...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200725060-00001

    authors: Gress S,Niebuhr D,May U,Wasem J

    更新日期:2007-01-01 00:00:00

  • Cost-Effectiveness of an Individualized First-Line Treatment Strategy Offering Erlotinib Based on EGFR Mutation Testing in Advanced Lung Adenocarcinoma Patients in Germany.

    abstract:BACKGROUND:Lung cancer is among the top causes of cancer-related deaths. Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors can increase progression-free survival compared with standard chemotherapy in patients with EGFR mutation-positive advanced non-small cell lung cancer (NSCLC). OBJECTIVE:The aim o...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-015-0305-8

    authors: Schremser K,Rogowski WH,Adler-Reichel S,Tufman AL,Huber RM,Stollenwerk B

    更新日期:2015-11-01 00:00:00

  • Oral ciprofloxacin: a pharmacoeconomic evaluation of its use in the treatment of serious infections.

    abstract::The broad spectrum of antibacterial activity and favourable pharmacokinetic profile of ciprofloxacin permit oral treatment of many serious infections which have traditionally necessitated parenteral antibacterial therapy. This has been demonstrated in comparative studies, in which ciprofloxacin was as effective and w...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199303050-00007

    authors: Balfour JA,Faulds D

    更新日期:1993-05-01 00:00:00

  • Correction to: A Budget Impact and Cost Per Additional Responder Analysis for Baricitinib for the Treatment of Moderate-to-Severe Rheumatoid Arthritis in Patients with an Inadequate Response to Tumor Necrosis Factor Inhibitors in the USA.

    abstract::Due to a single error in the annual cost of sarilumab the following needs to be corrected in the article. ...

    journal_title:PharmacoEconomics

    pub_type: 已发布勘误

    doi:10.1007/s40273-019-00857-7

    authors: Wehler E,Boytsov N,Nicolay C,Herrera-Restrepo O,Kowal S

    更新日期:2020-01-01 00:00:00

  • Epidemiology and burden of illness of rheumatoid arthritis.

    abstract::Rheumatoid arthritis (RA) is a chronic, generally progressive autoimmune disease that causes functional disability, significant pain and joint destruction, and leads to premature mortality. It is estimated to affect between 0.5 and 1.0% of the adult population worldwide, increases in prevalence with age and affects mo...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200422001-00002

    authors: Kvien TK

    更新日期:2004-01-01 00:00:00

  • Pharmacoeconomics of nonsteroidal anti-inflammatory drugs (NSAIDs).

    abstract::Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of the symptoms of osteoarthritis (OA), rheumatoid arthritis (RA), sprains and strains, sports injuries and menstrual disorders, and have a small role in the management of patent ductus arteriosus in the neonate. In patients with RA, symptom...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199303020-00004

    authors: Wynne HA,Campbell M

    更新日期:1993-02-01 00:00:00

  • Review of cost-benefit analyses of influenza vaccine.

    abstract::Vaccination is an underutilised, low cost and effective method of preventing illness. Cost-effectiveness analysis discloses a beneficial role of influenza vaccination in preventing illness especially in patients over 65 years of age and in high risk patients. In one large study, when 150 million doses of influenza v...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199202030-00003

    authors: Perez-Tirse J,Gross PA

    更新日期:1992-09-01 00:00:00

  • Choice of cost-effectiveness measure in the economic evaluation of cholesterol-modifying pharmacotherapy. An illustrative example focusing on the primary prevention of coronary heart disease in Canada.

    abstract:OBJECTIVE:To evaluate the effect of using different cost-effectiveness measures in the economic evaluation of cholesterol-modifying pharmacotherapy. DESIGN AND SETTING:An economic model was used to examine the extent to which the relative cost effectiveness of cholesterol-modifying agents varies depending upon the cos...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199916020-00008

    authors: Morris S,Godber E

    更新日期:1999-08-01 00:00:00

  • Integer/linear mathematical programming models: a tool for allocating healthcare resources.

    abstract::In today's environment, the demand for efficient healthcare resource allocation is increasing. As new technologies become available, allocation decisions become more complex and tools to assist decision makers in determining efficient allocations of healthcare resources are encouraged. Mathematical programs have multi...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200321120-00001

    authors: Earnshaw SR,Dennett SL

    更新日期:2003-01-01 00:00:00

  • Economic evaluation of levetiracetam as an add-on therapy in patients with refractory epilepsy.

    abstract:OBJECTIVES:This study provides the results of a cost-effectiveness analysis of levetiracetam as an adjunctive treatment for refractory epilepsy from the Canadian Ministry of Health perspective. The main objective is to estimate the expected cost-effectiveness ratio expressed as the incremental cost per seizure-free day...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200523050-00008

    authors: Blais L,Sheehy O,St-Hilaire JM,Bernier G,Godfroid P,LeLorier JJ

    更新日期:2005-01-01 00:00:00

  • Cost effectiveness of increasing the dose intensity of chemotherapy with granulocyte colony-stimulating factor in small-cell lung cancer: based on data from the Medical Research Council LU19 trial.

    abstract:BACKGROUND:The use of granulocyte colony-stimulating factor (G-CSF) can enable dose intensification of chemotherapy in small-cell lung cancer (SCLC). However, given its acquisition cost, it is important to assess its cost effectiveness within a resource-constrained health service. OBJECTIVE:To assess the cost effectiv...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200624050-00003

    authors: Bojke L,Sculpher M,Stephens R,Qian W,Thatcher N,Girling D

    更新日期:2006-01-01 00:00:00

  • EQ-5D Utilities in Chronic Spontaneous/Idiopathic Urticaria.

    abstract:OBJECTIVES:To obtain utility estimates suitable for use in economic models for chronic spontaneous (idiopathic) urticaria (CSU). METHODS:Patient-level data from three randomized clinical trials-ASTERIA I, ASTERIA II and GLACIAL-were analysed. Health states were derived from the Urticaria Activity Score over 7 days (UA...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-015-0375-7

    authors: Hawe E,McBride D,Balp MM,Tian H,Halliday A,Stull DE

    更新日期:2016-05-01 00:00:00

  • Pharmacoeconomic considerations in treating patients with acute leukaemia.

    abstract::Whereas individual cost-effectiveness analyses of new agents for acute leukaemia should be performed in target populations, any meaningful pharmacoeconomic evaluation of treatment options for this condition should include the many types of costs and outcomes in unselected, representative groups of patients. Both direc...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199915020-00005

    authors: Jønsson V,Hansen MM,Ljungman P,Kaasa S

    更新日期:1999-02-01 00:00:00

  • Discounting in cost-utility analysis of healthcare interventions: reassessing current practice.

    abstract::Cost-utility analysis (CUA) is a technique that can potentially be used as a guide to allocating healthcare resources so as to obtain the maximum health benefits possible under a given budget constraint. However, it is not clear that current practice captures societal preferences regarding health benefits. In analyses...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200321020-00001

    authors: Cohen BJ

    更新日期:2003-01-01 00:00:00

  • Developing health-related quality-of-life instruments for use in Asia: the issues.

    abstract::About half of the world's population live in Asia. Mandarin (the official language of China), Hindi and Japanese are among the ten languages spoken by the largest number of primary speakers. The numbers of Tamil and Malay speakers are expected to grow rapidly in the next few decades. Most health-related quality-of-lif...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200624070-00003

    authors: Cheung YB,Thumboo J

    更新日期:2006-01-01 00:00:00

  • Cefotaxime. A pharmacoeconomic review of its use in the treatment of infections.

    abstract::Cefotaxime is a parenterally administered third generation cephalosporin with a broad spectrum of antimicrobial activity. After more than a decade of use, cefotaxime continues to play an important role in the treatment of patients with serious infections, particularly those caused by Gram-negative bacteria. Clinical t...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199813010-00009

    authors: Plosker GL,Foster RH,Benfield P

    更新日期:1998-01-01 00:00:00

  • Vedolizumab for the Treatment of Adults with Moderate-to-Severe Active Ulcerative Colitis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    abstract::As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of vedolizumab (Takeda UK) to submit evidence of the clinical effectiveness and cost effectiveness of vedolizumab for the treatment of patients with moderate-to-severe active ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-015-0334-3

    authors: Essat M,Tappenden P,Ren S,Bessey A,Archer R,Wong R,Lobo A,Hoque S

    更新日期:2016-03-01 00:00:00

  • Cost effectiveness of dabrafenib as a first-line treatment in patients with BRAF V600 mutation-positive unresectable or metastatic melanoma in Canada.

    abstract:OBJECTIVE:To evaluate the cost effectiveness of dabrafenib versus dacarbazine and vemurafenib as first-line treatments in patients with BRAF V600 mutation-positive unresectable or metastatic melanoma from a Canadian healthcare system perspective. METHODS:A partitioned-survival analysis model with three mutually exclus...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-014-0241-z

    authors: Delea TE,Amdahl J,Wang A,Amonkar MM,Thabane M

    更新日期:2015-04-01 00:00:00

  • Evaluating Cost-Effectiveness Models for Pharmacologic Interventions in Adults with Heart Failure: A Systematic Literature Review.

    abstract:BACKGROUND:Heart failure (HF) is a well-recognized public health concern and imposes high economic and societal costs. Decision analytic models exist for evaluating the economic ramifications associated with HF. Despite this, studies that appraise these modelling approaches for augmenting best-practice decisions remain...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0755-x

    authors: Di Tanna GL,Bychenkova A,O'Neill F,Wirtz HS,Miller P,Ó Hartaigh B,Globe G

    更新日期:2019-03-01 00:00:00

  • The costs of treating breast cancer in the US: a synthesis of published evidence.

    abstract::Published estimates for the treatment costs of breast cancer vary widely in methodology, perspective, patient populations and time horizon. We systematically summarized and analysed the published literature on per-patient costs of breast cancer, and highlight the perspectives, populations studied, time horizons and fu...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,meta分析,评审

    doi:10.2165/00019053-200927030-00003

    authors: Campbell JD,Ramsey SD

    更新日期:2009-01-01 00:00:00

  • A Systematic Review of Economic Evaluations of Pharmacogenetic Testing for Prevention of Adverse Drug Reactions.

    abstract:BACKGROUND:Pharmacogenetics offers the potential to improve health outcomes by identifying individuals who are at greater risk of harm from certain medicines. Routine adoption of pharmacogenetic tests requires evidence of their cost effectiveness. OBJECTIVE:The present review aims to systematically review published ec...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-016-0397-9

    authors: Plumpton CO,Roberts D,Pirmohamed M,Hughes DA

    更新日期:2016-08-01 00:00:00

  • Barrett's oesophagus: a review of costs of the illness.

    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

    authors: Arguedas MR,Eloubeidi MA

    更新日期:2001-01-01 00:00:00

  • Parent-proxy EQ-5D ratings of children with attention-deficit hyperactivity disorder in the US and the UK.

    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

    authors: Matza LS,Secnik K,Mannix S,Sallee FR

    更新日期:2005-01-01 00:00:00

  • The cost effectiveness of amoxicillin/clavulanic acid as antibacterial prophylaxis in abdominal and gynaecological surgery.

    abstract::The objective of this study was to compare the cost effectiveness of amoxicillin/clavulanic acid with other antibacterial regimens for prophylaxis of infection after elective abdominal or gynaecological surgery. Data from 21 previously published comparative clinical trials were used to calculate statistical confidence...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00019053-199507040-00008

    authors: Davey PG,Parker SE,Crombie IK,Jaderberg M

    更新日期:1995-04-01 00:00:00

  • Economic evaluation of three two-drug chemotherapy regimens in advanced non-small-cell lung cancer.

    abstract:BACKGROUND:During the 1990s, a number of new cytotoxic agents with clinically relevant activity in non-small-cell lung cancer (NSCLC), and with a more favourable therapeutic index than drugs already in use, became available. Given the high prices of these new drugs and the large number of patients affected, it is impor...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200523110-00007

    authors: Neymark N,Lianes P,Smit EF,van Meerbeeck JP

    更新日期:2005-01-01 00:00:00

  • Economic and health-related quality of life considerations of new therapies in Parkinson's disease.

    abstract::The progressive disability of Parkinson's disease results in substantial burdens for patients, their families and society in terms of increased health resource use, poorer quality of life, caregiver burden, disrupted family relationships, decreases in social and leisure activities, deteriorating emotional well-being, ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200119070-00003

    authors: Rubenstein LM,DeLeo A,Chrischilles EA

    更新日期:2001-01-01 00:00:00

  • A prospective cost-consequence analysis of adding lamivudine to zidovudine-containing antiretroviral treatment regimens for HIV infection in the US.

    abstract:BACKGROUND:Healthcare resource use data were collected for 1 year as part of the CAESAR (Canada, Australia, Europe, South Africa) clinical trial, which evaluated the effect of adding lamivudine to treatment regimens containing zidovudine in patients with HIV infection. This study showed that lamivudine-containing regim...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2165/00019053-199915001-00003

    authors: Lacey L,Mauskopf J,Lindrooth R,Pham S,Saag M,Sawyer W

    更新日期:1999-01-01 00:00:00

  • Economic considerations related to providing adequate pain relief for women in labour: comparison of epidural and intravenous analgesia.

    abstract::Epidural analgesia and intravenous analgesia with opioids are two techniques for providing pain relief for women in labour. Labour pain is comparable to surgical pain in its severity, and epidural analgesia provides better relief from this pain than intravenous analgesia; a meta-analysis quantified this improvement to...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200220050-00002

    authors: Huang C,Macario A

    更新日期:2002-01-01 00:00:00

  • Sensitivity analysis in cost-effectiveness studies: from guidelines to practice.

    abstract::Cost-effectiveness analysis (CEA) is one of the main tools of economic evaluation. Every CEA is based on a number of assumptions, some of which may not be accurate, introducing uncertainty. Sensitivity analysis (SA) formalizes ways to measure and evaluate this uncertainty. Specific sources of uncertainty in CEA have b...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/11584630-000000000-00000

    authors: Jain R,Grabner M,Onukwugha E

    更新日期:2011-04-01 00:00:00

  • Replicating Health Economic Models: Firm Foundations or a House of Cards?

    abstract::Health economic evaluation is a framework for the comparative analysis of the incremental health gains and costs associated with competing decision alternatives. The process of developing health economic models is usually complex, financially expensive and time-consuming. For these reasons, model development is someti...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-017-0553-x

    authors: Bermejo I,Tappenden P,Youn JH

    更新日期:2017-11-01 00:00:00