IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v31y2011i1p35-42.html
   My bibliography  Save this article

Treatment Evolution and New Standards of Care

Author

Listed:
  • Steven M. Shechter

Abstract

Background. Traditional approaches to cost-effectiveness analysis have not considered the downstream possibility of a new standard of care coming out of the research and development pipeline. However, the treatment landscape for patients may change significantly over the course of their lifetimes. Objective. To present a Markov modeling framework that incorporates the possibility of treatment evolution into the incremental cost-effectiveness ratio (ICER) that compares treatments available at the present time. Design. Markov model evaluated by matrix algebra. Measurements. The author evaluates the difference between the new and traditional ICER calculations for patients with chronic diseases facing a lifetime of treatment. Results. The bias of the traditional ICER calculation may be substantial, with further testing revealing that it may be either positive or negative depending on the model parameters. The author also performs probabilistic sensitivity analyses with respect to the possible timing of a new treatment discovery and notes the increase in the magnitude of the bias when the new treatment is likely to appear sooner rather than later. Limitations. The modeling framework is intended as a proof of concept and therefore makes simplifying assumptions such as time stationarity of model parameters and consideration of a single new drug discovery. Conclusions. For diseases with a more active research and development pipeline, the possibility of a new treatment paradigm may be at least as important to consider in sensitivity analysis as other parameters that are often considered.

Suggested Citation

  • Steven M. Shechter, 2011. "Treatment Evolution and New Standards of Care," Medical Decision Making, , vol. 31(1), pages 35-42, January.
  • Handle: RePEc:sae:medema:v:31:y:2011:i:1:p:35-42
    DOI: 10.1177/0272989X10364849
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X10364849
    Download Restriction: no

    File URL: https://libkey.io/10.1177/0272989X10364849?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Emmett B. Keeler & Shan Cretin, 1983. "Discounting of Life-Saving and Other Nonmonetary Effects," Management Science, INFORMS, vol. 29(3), pages 300-306, March.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    3. Steven M. Shechter & Matthew D. Bailey & Andrew J. Schaefer & Mark S. Roberts, 2008. "The Optimal Time to Initiate HIV Therapy Under Ordered Health States," Operations Research, INFORMS, vol. 56(1), pages 20-33, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Morteza BAGHERPOUR, 2015. "Risky Time Driven Activity Based Costing in a Medical Center: A Development, Implementation and Simulation based Optimization Approach," The Journal of Accounting and Management, Danubius University of Galati, issue 2, pages 47-61, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Turgay Ayer & Can Zhang & Anthony Bonifonte & Anne C. Spaulding & Jagpreet Chhatwal, 2019. "Prioritizing Hepatitis C Treatment in U.S. Prisons," Operations Research, INFORMS, vol. 67(3), pages 853-873, May.
    2. Oguzhan Alagoz & Jagpreet Chhatwal & Elizabeth S. Burnside, 2013. "Optimal Policies for Reducing Unnecessary Follow-Up Mammography Exams in Breast Cancer Diagnosis," Decision Analysis, INFORMS, vol. 10(3), pages 200-224, September.
    3. Lauren E. Cipriano & Thomas A. Weber, 2018. "Population-level intervention and information collection in dynamic healthcare policy," Health Care Management Science, Springer, vol. 21(4), pages 604-631, December.
    4. Brousselle, Astrid & Lessard, Chantale, 2011. "Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path," Social Science & Medicine, Elsevier, vol. 72(6), pages 832-839, March.
    5. Paal Joranger & Arild Nesbakken & Halfdan Sorbye & Geir Hoff & Arne Oshaug & Eline Aas, 2020. "Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 321-334, April.
    6. Thaddeus L Miller & Scott J N McNabb & Peter Hilsenrath & Jotam Pasipanodya & Stephen E Weis, 2009. "Personal and Societal Health Quality Lost to Tuberculosis," PLOS ONE, Public Library of Science, vol. 4(4), pages 1-7, April.
    7. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    8. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    9. Laurence M. Djatche & Stefan Varga & Robert D. Lieberthal, 2018. "Cost-Effectiveness of Aspirin Adherence for Secondary Prevention of Cardiovascular Events," PharmacoEconomics - Open, Springer, vol. 2(4), pages 371-380, December.
    10. Ties Hoomans & Johan Severens & Nicole Roer & Gepke Delwel, 2012. "Methodological Quality of Economic Evaluations of New Pharmaceuticals in the Netherlands," PharmacoEconomics, Springer, vol. 30(3), pages 219-227, March.
    11. Khan, Md. Tajuddin & Kishore, Avinash & Joshi, Pramod Kumar, 2016. "Gender dimensions on farmers’ preferences for direct-seeded rice with drum seeder in India:," IFPRI discussion papers 1550, International Food Policy Research Institute (IFPRI).
    12. Noémi Kreif & Richard Grieve & M. Zia Sadique, 2013. "Statistical Methods For Cost‐Effectiveness Analyses That Use Observational Data: A Critical Appraisal Tool And Review Of Current Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 486-500, April.
    13. Barbara Graaff & Lei Si & Amanda L. Neil & Kwang Chien Yee & Kristy Sanderson & Lyle C. Gurrin & Andrew J. Palmer, 2017. "Population Screening for Hereditary Haemochromatosis in Australia: Construction and Validation of a State-Transition Cost-Effectiveness Model," PharmacoEconomics - Open, Springer, vol. 1(1), pages 37-51, March.
    14. Christopher Fitzpatrick & Katherine Floyd, 2012. "A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 63-80, January.
    15. Hareth Al-Janabi & Terry N. Flynn & Joanna Coast, 2011. "Estimation of a Preference-Based Carer Experience Scale," Medical Decision Making, , vol. 31(3), pages 458-468, May.
    16. Mason, J.E. & Denton, B.T. & Shah, N.D. & Smith, S.A., 2014. "Optimizing the simultaneous management of blood pressure and cholesterol for type 2 diabetes patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 727-738.
    17. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    18. Ching-Yun Wei & Ruben G. W. Quek & Guillermo Villa & Shravanthi R. Gandra & Carol A. Forbes & Steve Ryder & Nigel Armstrong & Sohan Deshpande & Steven Duffy & Jos Kleijnen & Peter Lindgren, 2017. "A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies," PharmacoEconomics, Springer, vol. 35(3), pages 297-318, March.
    19. Jose L Burgos & Thomas L Patterson & Joshua S Graff-Zivin & James G Kahn & M Gudelia Rangel & M Remedios Lozada & Hugo Staines & Steffanie A Strathdee, 2016. "Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-15, February.
    20. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:31:y:2011:i:1:p:35-42. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.