Expected Value of Perfect Information: An Empirical Example of Reducing Decision Uncertainty by Conducting Additional Research

Oostenbrink, Jan B.; Al, Maiwenn; Oppe, Mark; Mölken, Maureen P.M.H. Rutten-van

doi:10.1111/j.1524-4733.2008.00389.x

Cited by 57 publications

(60 citation statements)

References 46 publications

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“…We estimated the likelihood of each treatment strategy being the more favorable across a range of willingness-to-pay (WTP) thresholds. To assess the value of additional information, we calculated the expected value of perfect information (EVPI) with a 20-year lifespan of the testing technology and a partial EVPI (EVPPI) for the input parameters at various WTP thresholds [38]. From the 24% prevalence of AMCI and population estimates in Canada, we estimated the number of AMCI patients aged 70 years and older in Canada to be 275,000.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Genetic Testing in Combination with Preventive Donepezil Treatment for Patients with Amnestic Mild Cognitive Impairment

et al. 2012

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Using presently available clinical evidence, this exploratory study illustrates that genetic testing combined with preventive donepezil treatment for AMCI patients may be economically attractive. Since our results were based on a secondary post hoc analysis, our study alone is insufficient to warrant recommending APOE genotyping in AMCI patients. Future research on the effectiveness of preventive donepezil as a targeted therapy is recommended.

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Section: Sensitivity Analysismentioning

confidence: 99%

Genetic Testing in Combination with Preventive Donepezil Treatment for Patients with Amnestic Mild Cognitive Impairment

et al. 2012

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“…The model itself has been described in detail previously [12][13][14]. In short, it is a state-transition Markov model with four states: three COPD severity stages (moderate, severe and very severe) and death.…”

Section: Model-based Extrapolationmentioning

confidence: 99%

“…First, a trial-based economic evaluation was performed alongside the POET-COPD trial to estimate the cost-effectiveness in terms of costs per exacerbation avoided and costs per exacerbation day avoided. Second, the results of the POET-COPD trial were synthesised with evidence on COPD exacerbations from previous tiotropium studies [5,10,11] and this information was then used as input into a previously published COPD cost-effectiveness model [12][13][14]. The aim of the model-based analysis was to extrapolate trial results up to 5 yrs, to adjust the trial-based COPD severity distribution to a populationbased severity distribution and to estimate the costs per quality-adjusted life year (QALY).…”

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confidence: 99%

Cost-effectiveness of tiotropiumversussalmeterol: the POET-COPD trial

Hoogendoorn

Al²,

Beeh

et al. 2012

Eur Respir J

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The aim of this study was to perform a 1-yr trial-based cost-effectiveness analysis (CEA) of tiotropium versus salmeterol followed by a 5-yr model-based CEA.The within-trial CEA, including 7,250 patients with moderate to very severe chronic obstructive pulmonary disease (COPD), was performed alongside the 1-yr international randomised controlled Prevention of Exacerbations with Tiotropium (POET)-COPD trial comparing tiotropium with salmeterol regarding the effect on exacerbations. Main end-points of the trial-based analysis were costs, number of exacerbations and exacerbation days. The model-based analysis was conducted to extrapolate results to 5 yrs and to calculate quality-adjusted life years (QALYs).1-yr costs per patient from the German statutory health insurance (SHI) perspective and the societal perspective were J126 (95% uncertainty interval (UI) J55-195) and J170 (95% UI J77-260) higher for tiotropium, respectively. The annual number of exacerbations was 0.064 (95% UI 0.010-0.118) lower for tiotropium, leading to a reduction in exacerbation-related costs of J87 (95% UI J19-157). The incremental cost-effectiveness ratio was J1,961 per exacerbation avoided from the SHI perspective and J2,647 from the societal perspective. In the model-based analyses, the 5-yr costs per QALY were J3,488 from the SHI perspective and J8,141 from the societal perspective.Tiotropium reduced exacerbations and exacerbation-related costs, but increased total costs. Tiotropium can be considered cost-effective as the resulting cost-effectiveness ratios were below commonly accepted willingness-to-pay thresholds.KEYWORDS: Chronic obstructive pulmonary disease, costs, exacerbations, model, qualityadjusted life year, trial T he current international guidelines for the treatment of chronic obstructive pulmonary disease (COPD) recommend regular treatment with a long-acting anticholinergic drug (tiotropium) or a long-acting b-agonist (salmeterol, formoterol or indacaterol) for patients with moderate to very severe COPD [1]. These bronchodilators have been shown to improve symptoms, health-related quality of life and lung function, and reduce exacerbations and hospitalisations [2][3][4]. However, guidelines do not give a preference for either drug class. Until the publication of the Prevention of Exacerbations with Tiotropium (POET)-COPD trial, head-to-head comparisons were limited, had a short duration and/or were underpowered to detect a difference in COPD exacerbations [5,6]. The 1-yr POET-COPD trial was designed to compare the effects of tiotropium 18 mg once daily or salmeterol 50 mg twice daily on the occurrence of moderate or severe exacerbations in patients with moderate to very severe COPD and a history of least one exacerbation in the previous year [7]. This clinical trial demonstrated that tiotropium prolonged the time to first exacerbation (hazard ratio (HR) 0.83, 95% CI 0.77-0.90) and the time to first exacerbation leading to hospitalisation (HR 0.72, 95% CI 0.61-0.85), and reduced the total number of exacerbations (...

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“…First, it helps the decision maker in assessing how much gain could be obtained by reducing the uncertainty on the uncertain parameters (e.g. Oostenbrink et al (2008)). Second, it can be used as a lower bound for the optimal value of the true uncertain problem.…”

Section: Introductionmentioning

confidence: 99%

A perfect information lower bound for robust lot-sizing problems

2018

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Robust multi-stage linear optimization is hard computationally and only small problems can be solved exactly. Hence, robust multi-stage linear problems are typically addressed heuristically through decision rules, which provide upper bounds for the optimal solution costs of the problems. We investigate in this paper lower bounds inspired by the perfect information relaxation used in stochastic programming. Specifically, we study the uncapacitated robust lot-sizing problem, showing that different versions of the problem become tractable whenever the non-anticipativity constraints are relaxed. Hence, we can solve the resulting problem efficiently, obtaining a lower bound for the optimal solution cost of the original problem. We compare numerically the solution time and the quality of the new lower bound with the dual affine decision rules that have been proposed by Kuhn et al. (2011).

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Expected Value of Perfect Information: An Empirical Example of Reducing Decision Uncertainty by Conducting Additional Research

Abstract: This VOI analysis clearly identified parameters for which additional research is most worthwhile. After conducting additional research on the most important parameter, i.e., the utilities, total EVPI was substantially reduced.

Cited by 57 publications

References 46 publications

Genetic Testing in Combination with Preventive Donepezil Treatment for Patients with Amnestic Mild Cognitive Impairment

Genetic Testing in Combination with Preventive Donepezil Treatment for Patients with Amnestic Mild Cognitive Impairment

Cost-effectiveness of tiotropiumversussalmeterol: the POET-COPD trial

A perfect information lower bound for robust lot-sizing problems

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