IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v35y2015i5p671-682.html
   My bibliography  Save this article

Exploring the Potential Cost-Effectiveness of Patient Decision Aids for Use in Adults with Obstructive Sleep Apnea

Author

Listed:
  • Logan Trenaman
  • Mohsen Sadatsafavi
  • Fernanda Almeida
  • Najib Ayas
  • Larry Lynd
  • Carlo Marra
  • Dawn Stacey
  • Nick Bansback

Abstract

Background . There is increasing evidence highlighting the effectiveness of patient decision aids (PtDAs), but evidence supporting their cost-effectiveness is lacking. We consider patients with obstructive sleep apnea (OSA), in whom a PtDA may decrease nonadherence to treatment by empowering patients to receive the option that is most congruent with their own values. Objective . To determine the potential costs and benefits of delivering a PtDA to patients with moderate OSA. Methods . A Markov cohort decision-analytic model was developed for patients with moderate OSA, comparing a PtDA to usual care over 5 years from a societal perspective. Data for patient preference for treatment options was taken from a recent randomized crossover trial, event data (cardiovascular, motor vehicle accidents) came from national databases and published literature. Potential improvements in adherence are unknown, so we considered a realistic range of values. Outcome measures were 5-year costs (in 2010 Canadian dollars), quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). Results . When adherence to treatment was unchanged, the PtDA strategy was dominated by incurring lower QALYs and higher costs. When nonadherence was decreased by 20% in the PtDA arm (corresponding to an increase in adherence from 63% to 70% for continuous positive airway pressure and from 77% to 82% for mandibular advancement splints in year 1), the ICER fell to $62,414/QALY. Costs associated with the treatment devices and delivering the PtDA had the greatest effect on cost-effectiveness. Limitations . The model relies on surrogate measures and opinions for key parameters. Conclusions: The cost-effectiveness of PtDAs will depend on contextual factors, but a framework is described for properly considering their long-term cost-effectiveness. A number of important questions around the appropriateness of benefit measurement for PtDA trials are highlighted.

Suggested Citation

  • Logan Trenaman & Mohsen Sadatsafavi & Fernanda Almeida & Najib Ayas & Larry Lynd & Carlo Marra & Dawn Stacey & Nick Bansback, 2015. "Exploring the Potential Cost-Effectiveness of Patient Decision Aids for Use in Adults with Obstructive Sleep Apnea," Medical Decision Making, , vol. 35(5), pages 671-682, July.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:5:p:671-682
    DOI: 10.1177/0272989X14556676
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X14556676
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X14556676?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. Brazier, John & Ratcliffe, Julie & Salomon, Joshua & Tsuchiya, Aki, 2016. "Measuring and Valuing Health Benefits for Economic Evaluation," OUP Catalogue, Oxford University Press, edition 2, number 9780198725923.
    Full references (including those not matched with items on IDEAS)

    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. Joanna M Charles & Deirdre M Harrington & Melanie J Davies & Charlotte L Edwardson & Trish Gorely & Danielle H Bodicoat & Kamlesh Khunti & Lauren B Sherar & Thomas Yates & Rhiannon Tudor Edwards, 2019. "Micro-costing and a cost-consequence analysis of the ‘Girls Active’ programme: A cluster randomised controlled trial," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-17, August.
    2. Stevens, K, 2010. "Valuation of the Child Health Utility Index 9D (CHU9D)," MPRA Paper 29938, University Library of Munich, Germany.
    3. Brazier, JE & Yang, Y & Tsuchiya, A, 2008. "A review of studies mapping (or cross walking) from non-preference based measures of health to generic preference-based measures," MPRA Paper 29808, University Library of Munich, Germany.
    4. Ian M. McCarthy, 2015. "Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment," Health Economics, John Wiley & Sons, Ltd., vol. 24(12), pages 1588-1603, December.
    5. Zhongliang Zhou & Yu Fang & Zhiying Zhou & Dan Li & Dan Wang & Yanli Li & Li Lu & Jianmin Gao & Gang Chen, 2017. "Assessing Income-Related Health Inequality and Horizontal Inequity in China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 132(1), pages 241-256, May.
    6. Eliza Lai Yi Wong & Richard Huan Xu & Annie Wai Ling Cheung, 2020. "Health-related quality of life in elderly people with hypertension and the estimation of minimally important difference using EQ-5D-5L in Hong Kong SAR, China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(6), pages 869-879, August.
    7. Billingsley Kaambwa & Gang Chen & Julie Ratcliffe & Angelo Iezzi & Aimee Maxwell & Jeff Richardson, 2017. "Mapping Between the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and Five Multi-Attribute Utility Instruments (MAUIs)," PharmacoEconomics, Springer, vol. 35(1), pages 111-124, January.
    8. Donna Rowen & John Brazier & Anju Keetharuth & Aki Tsuchiya & Clara Mukuria, 2016. "Comparison of Modes of Administration and Alternative Formats for Eliciting Societal Preferences for Burden of Illness," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 89-104, February.
    9. Louis S. Matza & Katherine J. Kim & Holly Yu & Katherine A. Belden & Antonia F. Chen & Mark Kurd & Bruce Y. Lee & Jason Webb, 2019. "Health state utilities associated with post-surgical Staphylococcus aureus infections," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 819-827, August.
    10. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    11. Richard Cookson & Owen Cotton-Barrett & Matthew Adler & Miqdad Asaria & Toby Ord, 2016. "Years of good life based on income and health: Re-engineering cost-benefit analysis to examine policy impacts on wellbeing and distributive justice," Working Papers 132cherp, Centre for Health Economics, University of York.
    12. Thébaut, Clémence, 2013. "Dealing with moral dilemma raised by adaptive preferences in health technology assessment: The example of growth hormones and bilateral cochlear implants," Social Science & Medicine, Elsevier, vol. 99(C), pages 102-109.
    13. Georgina Jones & Victoria Brennan & Richard Jacques & Hilary Wood & Simon Dixon & Stephen Radley, 2018. "Evaluating the impact of a ‘virtual clinic’ on patient experience, personal and provider costs of care in urinary incontinence: A randomised controlled trial," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-16, January.
    14. Thomas Butt & Adnan Tufail & Gary Rubin, 2017. "Health State Utility Values for Age-Related Macular Degeneration: Review and Advice," Applied Health Economics and Health Policy, Springer, vol. 15(1), pages 23-32, February.
    15. Hareth Al‐Janabi, 2018. "Do capability and functioning differ? A study of U.K. survey responses," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 465-479, March.
    16. Tuomas Korhonen & Virpi Sillanpää & Aki Jääskeläinen, 2023. "Anchor practices that guide horizontal performance measurement: an interventionist case study of the financial aspect of new technology implementation in healthcare," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 27(3), pages 787-816, September.
    17. Valentina Prevolnik Rupel & Marko Ogorevc, 2021. "EQ-5D-Y Value Set for Slovenia," PharmacoEconomics, Springer, vol. 39(4), pages 463-471, April.
    18. Brazier, John & Rowen, Donna & Tsuchiya, Aki & Yang, Yaling & Young, Tracy A., 2011. "The impact of adding an extra dimension to a preference-based measure," Social Science & Medicine, Elsevier, vol. 73(2), pages 245-253, July.
    19. Mitchell, Paul Mark & Roberts, Tracy E. & Barton, Pelham M. & Coast, Joanna, 2015. "Assessing sufficient capability: A new approach to economic evaluation," Social Science & Medicine, Elsevier, vol. 139(C), pages 71-79.
    20. Hareth Al-Janabi & Nikki McCaffrey & Julie Ratcliffe, 2013. "Carer Preferences in Economic Evaluation and Healthcare Decision Making," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 6(4), pages 235-239, December.

    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:35:y:2015:i:5:p:671-682. 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.