New Article:
Adverse Events in Economic Decision Models: Insights from Ghabri, Dawoud and Drummond
When it comes to economic decision models in healthcare, incorporating adverse events (AEs) is crucial. However, as highlighted in a review paper by Salah Ghabri, Dalia Dawoud, and Michael Drummond, guidance on the standardization of incorporating AEs in economic models is lacking. Despite this, the paper offers valuable insights on how to tackle this issue. Here, we delve into different perspectives on the incorporation of AEs into economic models, the types of AEs to consider, estimating their impact on quality of life and costs, and addressing uncertainty related to their impact on the Incremental Cost-Effectiveness Ratio (ICER).
1. Ways to incorporate AEs into economic models:
One approach is to include AEs in the analytic model structure, where they are treated as a separate health state. Alternatively, AEs can be included as input parameters for each health state. This approach is more commonly used in the literature, with AEs often modeled from clinical trial data. However, long-term consequences of AEs are often overlooked.
2. Terminology and types of AEs to be included:
Adverse events may also be referred to as toxicity, side effects, or adverse drug effects. A key consideration is differentiating between chronic and acute AEs. Real-world data can be used to identify AEs, with post-market surveillance being mandatory for pharmaceuticals but not always for medical devices.
3. Estimating the impact of AEs on QoL and Costs:
Various methods can be used to estimate the impact of AEs on quality of life, with utility decrements being a common approach. However, challenges arise in determining the frequency and duration of AEs. On the cost side, most models focus on hospitalization costs for severe events.
4. Uncertainty around the impact of AEs on ICER:
While scenario analyses around AEs are rarely conducted, long-term AEs can have a significant impact on cost-effectiveness evaluations. For example, excluding AEs associated with depression and self-harm in a smoking cessation study affected the determination of cost-effective health strategies.
Despite the challenges highlighted, the authors offer best practices to help researchers address them. This article sheds light on the complexities of incorporating AEs into economic decision models and provides valuable insights for healthcare decision-makers.
FAQ:
Q: Why is it important to incorporate adverse events into economic models?
A: Incorporating adverse events in economic models is crucial for accurately assessing the cost-effectiveness of healthcare interventions and making informed decisions.
Q: What are some challenges in estimating the impact of adverse events on quality of life?
A: Challenges include determining the frequency and duration of adverse events, as well as ensuring that utility decrements are accurately captured without double-counting impacts on quality of life.
Q: How can researchers address uncertainty around the impact of adverse events on the ICER?
A: Conducting scenario analyses and considering long-term adverse events can help researchers better understand the potential impact on cost-effectiveness evaluations.
Conclusion:
In conclusion, the incorporation of adverse events into economic decision models poses various challenges, but it is essential for accurate cost-effectiveness evaluations in healthcare. By following best practices and considering long-term implications, researchers can better address uncertainties and make more informed decisions. The paper by Ghabri, Dawoud, and Drummond provides valuable insights and guidance in navigating this complex issue.