SIMPLIFIED Economic Evaluation Component

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Presentation transcript:

SIMPLIFIED Economic Evaluation Component Ed Wilson Health Economist CCTU How medics see economists How economists see medics

What is an economic evaluation? “The comparative analysis of alternative courses of action in terms of both their costs and consequences in order to assist policy decisions” ICER* Δ Δ * Incremental Cost Effectiveness Ratio

Why is economic evaluation important? Treatment Cost Health Gain Total

Economics component of SIMPLIFIED Cost effectiveness and cost utility analysis from the perspective of NHS secondary care Outcomes Life Years Gained / survival > ONS Quality Adjusted Life Years Gained (EQ5D5L) > Phone I/V Costs Drugs > UKRR Secondary care contacts > HES/UKRR OP, IP, DC diagnostics, dialysis, transplant, infections, CV event, malignancy, fracture, other events Follow-up time (time horizon of economic analysis) specific census points (rather than time to event) Primary: 4 years.

Methodological bolt-ons Decision modelling Synthesis of ‘all relevant evidence’ to inform a decision Project results to longer time horizon (less necessary in this case) “Interim value of information analysis” Iterative approach to evidence based decision making Define the decision problem Systematic review & Economic Evaluation Decision: Adopt or reject new technology? Value of information analysis More research worthwhile? End research into current decision problem Primary studies (RCT, epidemiological etc) Wilson & Abrams 2010

MRC Methodology Grant: Iterative VoI Routine databases Literature DEVELOP DECISION MODEL BASED ON CURRENT INFORMATION ONLY Expert Opinion Is Vit D cost-effective? How certain are we? Routine data (SIMPLIFIED) Demographics Secondary care prescriptions Dialysis attendance HRQoL Mortality Secondary end points NLSV data (SIMPLIFIED+) A&E contacts Non-renal related OP, IP Primary care contacts & prescriptions Social services received Out of pocket expenses Lost productivity Interim analysis UPDATE DECISION MODEL Is it worth continuing with NLSV data collection?

Status Model under development Panel meeting today (!) Hope to hear in next month or two…