Economic evaluation in chronic pain: a systematic review and de novo flexible economic model.
There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and...
| Publicado en: | European Journal of Health Economics Vol. 17; no. 6; pp. 755 - 771 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Jul2016
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115996438&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115996438 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16187598 V7V jtl: European Journal of Health Economics issn: 16187598 maglogo: N pubinfo: dt: Jul2016 vid: 17 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 115996438 115996438 NLM26377997 115996438 10.1007/s10198-015-0720-y NLM26377997 PMC4899502 115996438 ppf: 755 ppct: 16 formats: tig: atl: Economic evaluation in chronic pain: a systematic review and de novo flexible economic model. aug: au: Sullivan, W. Hirst, M. Beard, S. Gladwell, D. Fagnani, F. López Bastida, J. Phillips, C. Dunlop, W. López Bastida, J Dunlop, W C N affil: BresMed Health Solutions, Sheffield UK sug: subj: Chronic Pain Economics Cost Benefit Analysis Human Analgesics Adverse Effects Quality-Adjusted Life Years Analgesics Economics Narcotics Therapeutic Use Models, Statistical Narcotics Adverse Effects Analgesics Therapeutic Use Chronic Pain Therapy Narcotics Economics Systematic Review ab: There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and limitations in modelling approaches in the economic evaluation of treatments for chronic pain. The results of the literature review were then used to support the development of a fully flexible open-source economic model structure, designed to test structural and data assumptions and act as a reference for future modelling practice. The key model design themes identified from the systematic review included: time horizon; titration and stabilisation; number of treatment lines; choice/ordering of treatment; and the impact of parameter uncertainty (given reliance on expert opinion). Exploratory analyses using the model to compare a hypothetical novel therapy versus morphine as first-line treatments showed cost-effectiveness results to be sensitive to structural and data assumptions. Assumptions about the treatment pathway and choice of time horizon were key model drivers. Our results suggest structural model design and data assumptions may have driven previous cost-effectiveness results and ultimately decisions based on economic value. We therefore conclude that it is vital that future economic models in chronic pain are designed to be fully transparent and hope our open-source code is useful in order to aspire to a common approach to modelling pain that includes robust sensitivity analyses to test structural and parameter uncertainty. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|