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

2. 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

3. Why is economic evaluation important?
Treatment
Cost
Health Gain
Total

4. 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.

5. 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

6. 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?

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