IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v40y2020i8p1003-1019.html
   My bibliography  Save this article

Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands: A State Transition Model

Author

Listed:
  • Ingrid E. H. Kremer

    (Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, The Netherlands
    School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada)

  • Mickael Hiligsmann

    (Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, The Netherlands)

  • Josh Carlson

    (Department of Pharmacy, University of Washington, Seattle, WA, USA)

  • Marita Zimmermann

    (Institute for Disease Modeling, Bellevue, WA, USA)

  • Peter J. Jongen

    (MS4 Research Institute, Nijmegen, The Netherlands
    Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands)

  • Silvia M. A. A. Evers

    (Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, The Netherlands
    Centre for Economic Evaluations, Trimbos Institute, Utrecht, The Netherlands)

  • Svenja Petersohn

    (Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
    Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands)

  • Xavier G. L. V. Pouwels

    (Department of Health Technology & Services Research, Faculty of Behavioral, Management & Social Sciences, University of Twente, Enschede, The Netherlands)

  • Nick Bansback

    (School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada)

Abstract

Background Up to 31% of patients with relapsing-remitting multiple sclerosis (RRMS) discontinue treatment with disease-modifying drug (DMD) within the first year, and of the patients who do continue, about 40% are nonadherent. Shared decision making may decrease nonadherence and discontinuation rates, but evidence in the context of RRMS is limited. Shared decision making may, however, come at additional costs. This study aimed to explore the potential cost-effectiveness of shared decision making for RRMS in comparison with usual care, from a (limited) societal perspective over a lifetime. Methods An exploratory economic evaluation was conducted by adapting a previously developed state transition model that evaluates the cost-effectiveness of a range of DMDs for RRMS in comparison with the best supportive care. Three potential effects of shared decision making were explored: 1) a change in the initial DMD chosen, 2) a decrease in the patient’s discontinuation in using the DMD, and 3) an increase in adherence to the DMD. One-way and probabilistic sensitivity analyses of a scenario that combined the 3 effects were conducted. Results Each effect separately and the 3 effects combined resulted in higher quality-adjusted life years (QALYs) and costs due to the increased utilization of DMD. A decrease in discontinuation of DMDs influenced the incremental cost-effectiveness ratio (ICER) most. The combined scenario resulted in an ICER of €17,875 per QALY gained. The ICER was sensitive to changes in several parameters. Conclusion This study suggests that shared decision making for DMDs could potentially be cost-effective, especially if shared decision making would help to decrease treatment discontinuation. Our results, however, may depend on the assumed effects on treatment choice, persistence, and adherence, which are actually largely unknown.

Suggested Citation

  • Ingrid E. H. Kremer & Mickael Hiligsmann & Josh Carlson & Marita Zimmermann & Peter J. Jongen & Silvia M. A. A. Evers & Svenja Petersohn & Xavier G. L. V. Pouwels & Nick Bansback, 2020. "Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands: A State Transition Model," Medical Decision Making, , vol. 40(8), pages 1003-1019, November.
    • Handle: RePEc:sae:medema:v:40:y:2020:i:8:p:1003-1019
    DOI: 10.1177/0272989X20961091
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X20961091
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X20961091?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. Gisela Kobelt & J. Berg & P. Lindgren, 2006. "Costs and quality of life in multiple sclerosis in The Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(2), pages 55-64, July.
    2. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    3. Julia Krämer & Jan-Gerd Tenberge & Ingo Kleiter & Wolfgang Gaissmaier & Tobias Ruck & Christoph Heesen & Sven G Meuth, 2017. "Is the risk of progressive multifocal leukoencephalopathy the real reason for natalizumab discontinuation in patients with multiple sclerosis?," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-17, April.
    4. Gisela Kobelt & J. Berg & P. Lindgren, 2006. "Costs and quality of life in multiple sclerosis in The Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(02), pages 55-64, July.
    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. A. J. Hawton & C. Green, 2016. "Multiple sclerosis: relapses, resource use, and costs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(7), pages 875-884, September.
    2. Olivia Ernstsson & Hanna Gyllensten & Kristina Alexanderson & Petter Tinghög & Emilie Friberg & Anders Norlund, 2016. "Cost of Illness of Multiple Sclerosis - A Systematic Review," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-25, July.
    3. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    4. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    5. Christopher M Doran & Irina Kinchin, 2020. "Economic and epidemiological impact of youth suicide in countries with the highest human development index," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-11, May.
    6. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    7. Dongzhe Hong & Lei Si & Minghuan Jiang & Hui Shao & Wai-kit Ming & Yingnan Zhao & Yan Li & Lizheng Shi, 2019. "Cost Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists, and Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: A Systematic Review," PharmacoEconomics, Springer, vol. 37(6), pages 777-818, June.
    8. Simon Pol & Paula Rojas Garcia & Fernando Antoñanzas Villar & Maarten J. Postma & Antoinette D. I. Asselt, 2021. "Health-Economic Analyses of Diagnostics: Guidance on Design and Reporting," PharmacoEconomics, Springer, vol. 39(12), pages 1355-1363, December.
    9. Paul Revill & Simon Walker & Valentina Cambiano & Andrew Phillips & Mark J Sculpher, 2018. "Reflecting the real value of health care resources in modelling and cost-effectiveness studies—The example of viral load informed differentiated care," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    10. Omar B. Da'ar & Abdi A. Gele, 2023. "Tuberculosis in a weak health system, conflict and fragile zone: The monetary value of human lives lost associated with deaths of persons older than 14 years in Somalia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 38(1), pages 53-68, January.
    11. Anna Nicolet & Antoinette D I van Asselt & Karin M Vermeulen & Paul F M Krabbe, 2020. "Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-18, July.
    12. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    13. Nikolai Mühlberger & Gaby Sroczynski & Artemisa Gogollari & Beate Jahn & Nora Pashayan & Ewout Steyerberg & Martin Widschwendter & Uwe Siebert, 2021. "Cost effectiveness of breast cancer screening and prevention: a systematic review with a focus on risk-adapted strategies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1311-1344, November.
    14. Yasuhiro Hagiwara & Takeru Shiroiwa, 2022. "Estimating Value-Based Price and Quantifying Uncertainty around It in Health Technology Assessment: Frequentist and Bayesian Approaches," Medical Decision Making, , vol. 42(5), pages 672-683, July.
    15. Dina Jankovic & Pedro Saramago Goncalves & Lina Gega & David Marshall & Kath Wright & Meena Hafidh & Rachel Churchill & Laura Bojke, 2022. "Cost Effectiveness of Digital Interventions for Generalised Anxiety Disorder: A Model-Based Analysis," PharmacoEconomics - Open, Springer, vol. 6(3), pages 377-388, May.
    16. Boshen Jiao & Zafar Zafari & Brian Will & Kai Ruggeri & Shukai Li & Peter Muennig, 2017. "The Cost-Effectiveness of Lowering Permissible Noise Levels Around U.S. Airports," IJERPH, MDPI, vol. 14(12), pages 1-10, December.
    17. Stefan A. Lipman & Werner B. F. Brouwer & Arthur E. Attema, 2020. "What is it going to be, TTO or SG? A direct test of the validity of health state valuation," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1475-1481, November.
    18. Agbaya Stéphane Serge Oga & Akissi Régine Attia-konan & Fulgence Vehi & Jérôme Kouame & Kouamé Koffi, 2019. "Diabetic and cardiovascular patients’ willingness to pay for upcoming national health insurance scheme in Côte d’Ivoire," Health Economics Review, Springer, vol. 9(1), pages 1-8, December.
    19. Arthur E. Attema & Han Bleichrodt & Olivier L’Haridon & Patrick Peretti-Watel & Valérie Seror, 2018. "Discounting health and money: New evidence using a more robust method," Journal of Risk and Uncertainty, Springer, vol. 56(2), pages 117-140, April.
    20. B. Rodríguez-Sánchez & L. M. Peña-Longobardo & A. J. Sinclair, 2020. "Cost-effectiveness analysis of the Neuropad device as a screening tool for early diabetic peripheral neuropathy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 335-349, 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:40:y:2020:i:8:p:1003-1019. 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.