2020
DOI: 10.3389/fpubh.2020.569500
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On the Use of Markov Models in Pharmacoeconomics: Pros and Cons and Implications for Policy Makers

Abstract: We present an overview of the main methodological features and the goals of pharmacoeconomic models that are classified in three major categories: regression models, decision trees, and Markov models. In particular, we focus on Markov models and define a semi-Markov model on the cost utility of a vaccine for Dengue fever discussing the key components of the model and the interpretation of its results. Next, we identify some criticalities of the decision rule arising from a possible incorrect interpretation of … Show more

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Cited by 33 publications
(32 citation statements)
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“…Cost-effectiveness was established by the calculation of the incremental cost-effectiveness ratio (ICER) as incremental costs divided by incremental QALYs assuming the SOC strategy as reference. Costs and QALYs were discounted at 3% per year as performed in previous studies (10,17,38). The cost-effectiveness threshold was based on literature; the WHO recommends a threshold of up to three times the gross domestic product (GDP) per capita of the country (39).…”
Section: Model Calculationmentioning
confidence: 99%
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“…Cost-effectiveness was established by the calculation of the incremental cost-effectiveness ratio (ICER) as incremental costs divided by incremental QALYs assuming the SOC strategy as reference. Costs and QALYs were discounted at 3% per year as performed in previous studies (10,17,38). The cost-effectiveness threshold was based on literature; the WHO recommends a threshold of up to three times the gross domestic product (GDP) per capita of the country (39).…”
Section: Model Calculationmentioning
confidence: 99%
“…A deterministic sensitivity analysis (DSA) was performed to check the uncertainty of each parameter, allowing to determine an ICER range due to lower and higher changes in the input parameters in comparison to the base case scenario (10). For the efficacy parameter of asthma development in both AIT strategies, the range of values for DSA was defined based on the 95% confidence interval.…”
Section: Sensitivity Analysismentioning
confidence: 99%
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“…using a patient-level simulation). In fact, the Markovian modelling approach handles time from the beginning of the simulation rather that time spent in a health state [54], with the second requirement needed if patients were allowed to also step-up therapy (i.e. the model would need to track the time that patients spend on each treatment strategy to know when to stepdown after stepping-up).…”
Section: Discussionmentioning
confidence: 99%