Handling Uncertainty in Cost-Effectiveness Models
Top Cited Papers
- 1 May 2000
- journal article
- review article
- Published by Springer Science and Business Media LLC in PharmacoEconomics
- Vol. 17 (5), 479-500
- https://doi.org/10.2165/00019053-200017050-00006
Abstract
The use of modelling in economic evaluation is widespread, and it most often involves synthesising data from a number of sources. However, even when economic evaluations are conducted alongside clinical trials, some form of modelling is usually essential. The aim of this article is to review the handling of uncertainty in the cost-effectiveness results that are generated by the use of decision-analytic-type modelling. The modelling process is split into a number of stages: (i) a set of methods to be employed in a study are defined, which should include a ‘reference case’ of agreed methods to enhance the comparability of results; (ii) the clinical and demographic characteristics of the patients the model relates to should be specified as carefully as in any experimental study; and (iii) the data requirements of the model should be estimated using the principles of Bayesian statistics, such that prior distributions are specified for unknown model parameters. Monte Carlo simulation can then be employed to sample from these prior distributions to obtain a distribution of the cost effectiveness of the intervention. Such probabilistic analyses are related to parameter uncertainty. In addition, modelling uncertainty is likely to add a further layer of uncertainty to the results of particular analyses.Keywords
This publication has 55 references indexed in Scilit:
- An Introduction to Markov Modelling for Economic EvaluationPharmacoEconomics, 1998
- Accounting for future costs in medical cost-effectiveness analysisJournal of Health Economics, 1997
- The friction cost method for measuring indirect costs of diseaseJournal of Health Economics, 1995
- Costs, effects and C/E‐ratios alongside a clinical trialHealth Economics, 1994
- A Cost‐Utility Analysis of Misoprostol Prophylaxis for Rheumatoid Arthritis Patients Receiving Nonsteroidal Antiinflammatory DrugsArthritis & Rheumatism, 1994
- Discounting in Cost-Effectiveness Analysis of Healthcare ProgrammesPharmacoEconomics, 1993
- Discounting of Health Benefits in the Pharmacoeconomic Analysis of Drug TherapiesPharmacoEconomics, 1992
- A Bayesian Method for Synthesizing Evidence: The Confidence Profile MethodInternational Journal of Technology Assessment in Health Care, 1990
- Decision AnalysisThe New England Journal of Medicine, 1987
- Probabilistic sensitivity analysis methods for general decision modelsComputers and Biomedical Research, 1986