Modeling Treatment Sequences in Pharmacoeconomic Models

Ying Zheng, Feng Pan and Sonja Sorensen ()
Additional contact information
Ying Zheng: Evidera
Feng Pan: Janssen Global Services, LLC
Sonja Sorensen: Evidera

PharmacoEconomics, 2017, vol. 35, issue 1, No 3, 15-24

Abstract: Abstract As the number of interventions available in a therapeutic area increases, the relevant decision questions in health technology assessment (HTA) expand to compare treatment sequences instead of discrete treatments and identify optimal sequences or position for a particular treatment in a sequence. The objective of this work was to review approaches used to model treatment sequences and provide practical guidance on conceptualizing whether and how to model sequences in health economic models. Economic models including treatment sequencing assessed by the National Institute for Health and Care Excellence were reviewed, as these assessments generally provide both policy relevance and comprehensive model detail. We identified 40 treatment-sequence models in the following disease areas: oncology (13), autoimmune (7), cardiovascular (6), neurology/mental health (4), infectious disease (2), diabetes (2), and other (6). Modeling techniques included discrete event simulation (6), individual state-transition (3), decision tree (3) and, most commonly, cohort state-transition with tracking states (28). In most cases, treatment sequencing had been incorporated to reflect either clinical practice or clinical trial design. In other cases, it was used to assess where in a treatment sequence a new treatment should be placed, or to evaluate the addition of more efficacious treatment options to a current treatment sequence. Important considerations for determining how to best model sequences include the number of treatment options, patient heterogeneity, key outcomes, and event risk (time-varying or constant). The biggest challenge is the scarcity of clinical data, as clinical trials do not commonly evaluate different treatment sequences.

Date: 2017
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s40273-016-0455-3 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:pharme:v:35:y:2017:i:1:d:10.1007_s40273-016-0455-3

Ordering information: This journal article can be ordered from
http://www.springer.com/economics/journal/40273

DOI: 10.1007/s40273-016-0455-3

Access Statistics for this article

PharmacoEconomics is currently edited by Timothy Wrightson and Christopher I. Carswell

More articles in PharmacoEconomics from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().