Using Whole Disease Modeling to Inform Resource Allocation Decisions: Economic Evaluation of a Clinical Guideline for Colorectal Cancer Using a Single Model

Tappenden, Paul; Chilcott, Jim; Brennan, Alan; Squires, Hazel; Glynne-Jones, R.; Tappenden, Janine

doi:10.1016/j.jval.2013.02.012

Cited by 24 publications

(43 citation statements)

References 46 publications

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“…A methodological framework for "Whole Disease Modeling" has been developed by Tappenden et al, which considers all treatments and diagnostics along the pathway of care for a simulated cohort, 56 but the only examples that we could find of this method being used were with colorectal cancer and depression. 57,58 Multi-morbidity also has implications for quality of life outcome measures which, like costs, do not behave additively over conditions. 59 Outcome measures are also problematic in particular patient groups, such as those with impaired cognitive abilities who may not be able to complete patient reported outcome measures; 60 and in particular interventions, such as palliative care, where the choice of outcome is not straightforward or uniform.…”

Section: Discussionmentioning

confidence: 99%

Priorities for Health Economic Methodological Research: Results of an Expert Consultation

Tordrup¹,

Chouaïd

Cuijpers

et al. 2017

Int J Technol Assess Health Care

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Background: The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps.Methods: The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps.Results: The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities.Conclusions: The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the “-omics” approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.

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Section: Discussionmentioning

confidence: 99%

Priorities for Health Economic Methodological Research: Results of an Expert Consultation

Tordrup¹,

Chouaïd

Cuijpers

et al. 2017

Int J Technol Assess Health Care

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“…However, the timescale for transition between cancer stages and its relationship with symptomatology is much less well known. 137 Gaining this knowledge is a crucial step, as until we know what stage shift (if any) arises from the introduction of an intervention to expedite symptomatic cancer diagnosis, reliably estimating the benefits of such an approach will remain impossible. 138 Thus, reports of a small, but significant, stage shift following a cancer awareness campaign are doubly welcome.…”

Section: [H1] Health Economicsmentioning

confidence: 99%

Improving early diagnosis of symptomatic cancer

Hamilton

Walter

Rubin³

et al. 2016

Nat Rev Clin Oncol

115

125

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| Much time, effort and investment goes into the diagnosis of symptomatic cancer, with the expectation that this approach brings clinical benefits. This investment of resources has been particularly noticeable in the UK, which has, for several years, appeared near the bottom of international league tables for cancer survival in economically developed countries. This Review examines expedited diagnosis of cancer from four perspectives. The first examines the potential for benefits from expedited diagnosis of symptomatic cancer. Limited evidence from clinical trials is available, but the considerable observational evidence suggests benefits can be obtained from this approach. The second perspective considers how expedited diagnosis can be achieved. We concentrate on data from the UK, where extensive awareness campaigns have been conducted, and initiatives in primary care, including clinical decision support, have all occurred during a period of considerable national policy change. The third section considers the most appropriate patients for cancer investigations, and the possible community settings for this. UK national guidance for selection of patients for investigation is discussed. Finally, the health economics of the subject are reviewed, although few studies provide definitive evidence on this topic.In all developed countries, much time, effort and finance is spent on the diagnosis of cancer.

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“…A few disease-specific models have been previously published [15][16][17][18][19]. These are large-scale models with different boundaries, providing a consistent framework for the economic evaluation of a wide range of health technologies for a specific condition (e.g., rheumatoid arthritis, colorectal cancer).…”

Section: Introductionmentioning

confidence: 99%

“…These are large-scale models with different boundaries, providing a consistent framework for the economic evaluation of a wide range of health technologies for a specific condition (e.g., rheumatoid arthritis, colorectal cancer). Our proposed disease specific (reference) model is not a system-level model, such as a whole disease model, simulating disease and treatment pathways, i.e., prevention, diagnosis, and postdiagnosis pathways [18]. Rather, a disease-specific model focuses on the disease progression, capturing all key clinical states/events, and the transition between them, and patient attributes that influence disease and/or response to treatment.…”

Section: Introductionmentioning

confidence: 99%

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Development and Use of Disease-Specific (Reference) Models for Economic Evaluations of Health Technologies: An Overview of Key Issues and Potential Solutions

et al. 2015

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Using Whole Disease Modeling to Inform Resource Allocation Decisions: Economic Evaluation of a Clinical Guideline for Colorectal Cancer Using a Single Model

Cited by 24 publications

References 46 publications

Priorities for Health Economic Methodological Research: Results of an Expert Consultation

Priorities for Health Economic Methodological Research: Results of an Expert Consultation

Improving early diagnosis of symptomatic cancer

Development and Use of Disease-Specific (Reference) Models for Economic Evaluations of Health Technologies: An Overview of Key Issues and Potential Solutions

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