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Model-Based Cost-Effectiveness Analyses for the Treatment of Chronic Lymphocytic Leukaemia: A Review of Methods to Model Disease Outcomes and Estimate Utility

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  • Kevin Marsh
  • Peng Xu
  • Panagiotis Orfanos
  • James Gordon
  • Ingolf Griebsch

Abstract

Assessing the economic value of treatments for chronic lymphocytic leukaemia (CLL) is necessary to support healthcare decision makers; however, it poses a number of challenges. This paper reviews economic models of CLL treatment to learn the lessons from this experience and support ongoing model efforts. A search of databases and submissions to key health technology assessment agencies identified nine models. The modelling approaches adopted across these studies were fairly similar, with most models adopting a cohort Markov structure, though one example of a discrete event simulation was identified. While the cohort Markov approach has been acceptable to the National Institute for Health and Care Excellence, the review identifies a number of key uncertainties with these models, including the extrapolation of survival outcomes beyond the period observed by the trial, the effectiveness of second-line therapies, and estimates of health state utility. Further work is required to overcome these uncertainties, including comprehensive sensitivity analysis, systematic review of the evidence on the natural progression of CLL, and the collection of longer-term trial and registry data. Copyright Springer International Publishing Switzerland 2014

Suggested Citation

  • Kevin Marsh & Peng Xu & Panagiotis Orfanos & James Gordon & Ingolf Griebsch, 2014. "Model-Based Cost-Effectiveness Analyses for the Treatment of Chronic Lymphocytic Leukaemia: A Review of Methods to Model Disease Outcomes and Estimate Utility," PharmacoEconomics, Springer, vol. 32(10), pages 981-993, October.
    • Handle: RePEc:spr:pharme:v:32:y:2014:i:10:p:981-993
    DOI: 10.1007/s40273-014-0187-1
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    References listed on IDEAS

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    1. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
    2. Kevin Marsh & Peng Xu & Panagiotis Orfanos & Agnes Benedict & Kamal Desai & Ingolf Griebsch, 2014. "Model-Based Cost-Effectiveness Analyses for the Treatment of Chronic Myeloid Leukaemia: A Review and Summary of Challenges," PharmacoEconomics, Springer, vol. 32(9), pages 853-864, September.
    3. K. Ishak & Noemi Kreif & Agnes Benedict & Noemi Muszbek, 2013. "Overview of Parametric Survival Analysis for Health-Economic Applications," PharmacoEconomics, Springer, vol. 31(8), pages 663-675, August.
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