Cost-Effectiveness Analysis and Decision Modelling: A Tutorial for Clinicians

Publication date: Available online 26 November 2019Source: Journal of Clinical and Experimental HepatologyAuthor(s): Nidhi Gupta, Rohan Verma, Radha Krishan Dhiman, Kavitha Rajsekhar, Shankar PrinjaAbstractCost effectiveness analysis provides information on how much extra do we need to spend per unit gain in health outcomes with introduction of any new healthcare intervention or treatment as compared to the alternative. This information is crucial to make decision regarding funding any new drug, diagnostic test or determining standard treatment protocol. It becomes even more important to consider this evidence in resource constrained low and middle income country settings. Generating evidence on costs and consequences of a treatment or intervention could be done in the setting of a randomized controlled trial, which is the perfect platform to evaluate efficacy or effectiveness. However, we argue that RCT offers an incomplete setting to generate comprehensive data on all costs and consequences for the purpose of a cost-effectiveness analysis. Hence, it is needed to use a decision model, either in combination with the evidence from RCT or alone. In this paper, we demonstrate the application of decision model based economic evaluation using 2 separate techniques – a decision tree and a markov model. We argue that application of a decision model allows computation of health benefits in terms of utility based measure such as a quality adjusted life year or disability adjusted li...
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research