Multiple Effects Cost-Effectiveness Analysis in Cost-Disutility Space

McCaffrey, Nikki; Eckermann, Simon

doi:10.1007/978-3-319-50613-5_10

Cited by 2 publications

(6 citation statements)

References 32 publications

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“…In relation to coverage, adapting and extending NBCT methods with radar plot presentation in C-DU space and triangulation under uncertainty with bootstrapping methods have been shown to facilitate robust joint consideration across multiple effect domains alongside AOTG implementation cost. Importantly radar plot presentation in C-DU space retains the key advantages of the NBCT in enabling radial comparison consistent with maximising net benefit [ 10 – 13 , 25 , 26 ] while extending multiple effect presentation and triangulated uncertainty analysis to more than 3 dimensions. Like previous multiple domain of effect health economic research methods [ 25 , 26 ], health economic analysis undertaken in this paper extends deterministic cost consequences and single effect cost effectiveness categories to enable robust multiple domain cost effectiveness analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly radar plot presentation in C-DU space retains the key advantages of the NBCT in enabling radial comparison consistent with maximising net benefit [ 10 – 13 , 25 , 26 ] while extending multiple effect presentation and triangulated uncertainty analysis to more than 3 dimensions. Like previous multiple domain of effect health economic research methods [ 25 , 26 ], health economic analysis undertaken in this paper extends deterministic cost consequences and single effect cost effectiveness categories to enable robust multiple domain cost effectiveness analysis.…”

Section: Discussionmentioning

confidence: 99%

“…To robustly consider net incremental effects and undertake health economic analysis for community based health promotion interventions such as the AOTG program requires flexible methods for triangulating evidence [ 41 ] which respectively cover and facilitate: (i) Triangulation of prospective quantitative and qualitative evidence of program community level incremental pre-post effect change between randomised or matched communities [ 7 ]; and (ii) Robust evaluation under uncertainty of joint incremental effects with multiple dimension and domain comparisons across populations, and alongside costs for incremental cost effectiveness analysis [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…In relation to coverage the net benefit correspondence theorem (NBCT) has been shown to have unique advantages in enabling flexible while robust joint multiple effect and multiple strategy cost effectiveness analysis under uncertainty. Theses advantages arise with radial properties in framing effects from a disutility (DU) bearing perspective and considering them alongside cost [ 6 , 10 – 13 , 25 , 26 ]. Never-the-less previous NBCT methods in orthogonal cost-disutility (C-DU) space have been limited to 3-dimensional representation in joint consideration of 2 DU framed effects alongside costs.…”

Section: Methodsmentioning

confidence: 99%

“…Comparing between arms across 13 dimensions, relative disutility effect measures and cost are, as with previous NBCT methods, best presented using flexible axes for each dimension [ 11 , 25 , 26 ]. That is, for each strategy, each of their multiple disutility framed effects or cost dimensions can be measured relative to the lowest disutility or lowest cost strategy in comparing across strategies mean DU effect measures, or across replicates in uncertainty analysis.…”

Section: Methodsmentioning

confidence: 99%

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Multiple effects health economic evaluation of the Ahead of The Game Study for mental health promotion in sporting club communities

et al. 2021

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Background This study evaluates the Ahead Of The Game (AOTG) mental health promotion strategy for adolescent males relative to usual practice in team based sporting club community settings, allowing for joint incremental effects across 13 dimensions and 5 domains alongside intervention implementation costs. Methods Analysis is undertaken between matched communities with difference in differences analysis of joint multiple pre-post effect changes alongside implementation costs employing radar plots in cost-disutility space. A robust bootstrapping method allowed including all observed change in effect data from 343 AOTG and 273 control arm participants across 13 effect dimensions. Results Triangulation across joint evidence shows mean incremental effects favoured AOTG in all dimensions (10/13 significantly at 5% level) and in simple aggregation to each of five pre-specified 5 domains (each significant at < 1% level) and global measures (significant at 0.001% level), while mean AOTG implementation costs were conservatively estimated as $37.47 per participant. Conclusion The AOTG strategy was found to represent an effective mental health promotion strategy across all domains and globally with associated significant potential for downstream health system cost savings to offset against modest implementation costs. Evaluation methods extend conventional cost-effectiveness analysis to enable robust joint presentation and triangulation under uncertainty of multiple effect dimensions alongside costs. Trial registration ANZCTR, ACTRN12617000709347. Registered 17th May 2017.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Multiple effects health economic evaluation of the Ahead of The Game Study for mental health promotion in sporting club communities

et al. 2021

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Economic evaluation of the randomised, double-blind, placebo-controlled study of subcutaneous ketamine in the management of chronic cancer pain

et al. 2018

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Background: Treating chronic, uncontrolled, cancer pain with subcutaneous ketamine in patients unresponsive to opioids and co-analgesics remains controversial, especially in light of recent evidence demonstrating ketamine does not have net clinical benefit in this setting. Aim: To evaluate the cost-effectiveness of subcutaneous ketamine versus placebo in this patient population. Design and setting: A within-trial cost-effectiveness analysis of the Australian Palliative Care Clinical Studies Collaborative’s randomised, double-blind, placebo-controlled trial of ketamine was conducted from a healthcare provider perspective. Mean costs and outcomes were estimated from participant-level data over 5 days including positive response, health-related quality of life (HrQOL) measured with the Functional Assessment of Chronic Illness Therapy–Palliative Care (FACIT-Pal), ketamine costs, medication usage and in-patient stays. Results: There was no statistically significant difference in responder rates, but higher toxicity and worse HrQOL for ketamine participants (mean change −3.10 (standard error (SE) 1.76), ketamine n = 93; 4.53 (SE 1.38), placebo n = 92). Estimated total mean costs were AU$706 higher per ketamine participant (AU$6608) compared with placebo (AU$5902), attributable to the cost of higher in-patient costs as well as costs of ketamine administration. The results were robust to sensitivity analyses accounting for different medication use costing methods and removal of cost outliers. Conclusion: The findings suggest subcutaneous ketamine in conjunction with opioids and standard adjuvant therapy is neither an effective nor cost-effective treatment for refractory pain in advanced cancer patients.

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Multiple Effects Cost-Effectiveness Analysis in Cost-Disutility Space

Cited by 2 publications

References 32 publications

Multiple effects health economic evaluation of the Ahead of The Game Study for mental health promotion in sporting club communities

Multiple effects health economic evaluation of the Ahead of The Game Study for mental health promotion in sporting club communities

Economic evaluation of the randomised, double-blind, placebo-controlled study of subcutaneous ketamine in the management of chronic cancer pain

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