Mo3 Comparing Methods of Data Synthesis: Updating Parameters of an Existing Probabilistic Cost-Effectiveness Model

Oppe, Mark; Al, MJ; Mölken, MP Rutten-van

doi:10.1016/s1098-3015(10)66199-2

Cited by 3 publications

(7 citation statements)

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“…Several models had included some aspects of heterogeneity in the natural history of COPD, mainly through stratification of analysis on patient characteristics. Nevertheless, given the extent of heterogeneity in the natural history of COPD, and that only a fraction of such heterogeneity can be explained by observable traits [62,63], our conclusion is that heterogeneity was not fully Price et al (15) Ariza et al (16) Price et al (17) Spencer et al (18) Sun et al (19) Hertel et al (20) Samyshkin et al (21) Samyshkin et al (22) Vemer et al (23) Oostenbrink et al (24) Maniadakis et al (25) van Molken et al (26) Oostenbrink et al (27) Gani et al (28) Oppe et al (29) HeƩle et al (30) Hoogendoorn et al (31) Hoogendoorn et al (32) Hoogendoorn et al (33) van Boven et al (34) Zafari et al (35) Thorlund et al (36) Sin et al (37) Earnshaw et al (38) Chuck et al (39) Buist et al (40) Nielsen et al (41) Atsou et al (42) Oba et al (43) Oba accounted for. In cohort models (e.g., Markov models), violation of the homogeneity principle can cause bias in the estimated outcomes, even when the outcome of interest is costeffectiveness for the whole population [64].…”

Section: Discussionmentioning

confidence: 80%

“…Most of the models (n ¼ 40) were developed for the purpose of economic evaluation, either of alterative COPD treatments or of a COPD management program [13][14][15][16][17][18][19][20][21][22][24][25][26][27][28][30][31][32][33][34][37][38][39][42][43][44][45][46][47][48][49][50][51][52][54][55][56]58,60,61]. Two models [40,41] were developed to project the future burden of COPD; five models [23,29,35,36,53] represented a case study for methodological work; and two models [57,59] were developed as a generic modeling framework (multipurpose and n...…”

Section: Summary Of General Characteristics Of Models and Their Adhermentioning

confidence: 99%

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A Systematic Review of Health Economics Simulation Models of Chronic Obstructive Pulmonary Disease

et al. 2017

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Section: Discussionmentioning

confidence: 80%

Section: Summary Of General Characteristics Of Models and Their Adhermentioning

confidence: 99%

A Systematic Review of Health Economics Simulation Models of Chronic Obstructive Pulmonary Disease

et al. 2017

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“…Our group has previously investigated the effect of four different methods of meta-analysis on model-based CE estimates [9]. Although we found considerable differences, there was no way of knowing which of the methods was best, because we had no 'truth' to which we could compare our results.…”

Section: Introductionmentioning

confidence: 87%

A Choice That Matters?

Vemer

Oppe

et al. 2013

PharmacoEconomics

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“…First, a Bayesian fixed-effects meta-analysis was performed to synthesise the exacerbation probabilities in the tiotropium group of the POET-COPD trial, with the exacerbation probabilities in the tiotropium group of six tiotropium trials used to inform a previously published cost-effectiveness model [5,[10][11][12][13]24]. The relative exacerbation risks of salmeterol compared with tiotropium of the POET-COPD trial and the salmeterol-controlled tiotropium trials published by BRUSASCO et al [5] were combined with this method.…”

Section: Model-based Extrapolationmentioning

confidence: 99%

“…With respect to the input parameters of the model, the probabilities of moving between states and utility values by COPD severity stage and exacerbation severity remained unchanged and can be found elsewhere [12,26]. Data presented are the exacerbation probabilities resulting from Bayesian fixed-effects meta-analysis combining exacerbation data from the Prevention of Exacerbations with Tiotropium (POET) trial and exacerbation data from [5,[10][11][12][13]24]. Data are presented as mean¡SE.…”

Section: Model-based Extrapolationmentioning

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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Mo3 Comparing Methods of Data Synthesis: Updating Parameters of an Existing Probabilistic Cost-Effectiveness Model

Cited by 3 publications

References 0 publications

A Systematic Review of Health Economics Simulation Models of Chronic Obstructive Pulmonary Disease

A Systematic Review of Health Economics Simulation Models of Chronic Obstructive Pulmonary Disease

A Choice That Matters?

Cost-effectiveness of tiotropiumversussalmeterol: the POET-COPD trial

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