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The CHD challenge: comparing four cost-effectiveness models

The CHD challenge: comparing four cost-effectiveness models
The CHD challenge: comparing four cost-effectiveness models
Objectives: to compare four UK models evaluating the cost-effectiveness of interventions in coronary heart disease (CHD), exploring the relative importance of structure and inputs in accounting for differences, and the scope for consensus on structure and data.

Methods: we compared published cost-effectiveness results (incremental cost, quality-adjusted life year, and cost-effectiveness ratio) of three models conforming to the National Institute for Health and Clinical Excellence guidelines dealing with three interventions (statins, percutaneous coronary intervention, and clopidogrel) with a model developed in Southampton. Comparisons were made using three separate stages: 1) comparison of published results; 2) comparison of the results using the same data inputs wherever possible; and 3) an in-depth exploration of reasons for differences and the potential for consensus.

Results: although published results differed by up to 73% (for statins), standardization of inputs (stage 2) narrowed these gaps. Greater understanding of the reasons for differences was achieved, but a consensus on preferred values for all data inputs was not reached.

Conclusions: we found that published guidance on methods was important to reduce variation in important model inputs. Although the comparison of models did not lead to consensus for all model inputs, it provided a better understanding of the reasons for these differences, and enhanced the transparency and credibility of all models. Similar comparisons would be aided by fuller publication of models, perhaps through detailed web appendices
1098-3015
53-60
Turner, David
39dc4dc8-88b4-4950-8bbd-c647ff110ec9
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Fairbank, Eleanor
9d0179fe-aac9-4dbb-aa04-9315602b13f6
Palmer, Stephen
d320e69c-f0b8-490c-b80d-6522da8df44c
Ward, Sue
afa41245-9845-4a23-894e-7ac24c236289
Ara, Roberta
14971e70-5a76-40e3-bd9d-a8f0f23fc481
Turner, David
39dc4dc8-88b4-4950-8bbd-c647ff110ec9
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Cooper, Keith
ea064f58-d71d-404a-bcf3-49d243b8825b
Fairbank, Eleanor
9d0179fe-aac9-4dbb-aa04-9315602b13f6
Palmer, Stephen
d320e69c-f0b8-490c-b80d-6522da8df44c
Ward, Sue
afa41245-9845-4a23-894e-7ac24c236289
Ara, Roberta
14971e70-5a76-40e3-bd9d-a8f0f23fc481

Turner, David, Raftery, James, Cooper, Keith, Fairbank, Eleanor, Palmer, Stephen, Ward, Sue and Ara, Roberta (2011) The CHD challenge: comparing four cost-effectiveness models. Value in Health, 14 (1), 53-60. (doi:10.1016/j.jval.2010.10.009).

Record type: Article

Abstract

Objectives: to compare four UK models evaluating the cost-effectiveness of interventions in coronary heart disease (CHD), exploring the relative importance of structure and inputs in accounting for differences, and the scope for consensus on structure and data.

Methods: we compared published cost-effectiveness results (incremental cost, quality-adjusted life year, and cost-effectiveness ratio) of three models conforming to the National Institute for Health and Clinical Excellence guidelines dealing with three interventions (statins, percutaneous coronary intervention, and clopidogrel) with a model developed in Southampton. Comparisons were made using three separate stages: 1) comparison of published results; 2) comparison of the results using the same data inputs wherever possible; and 3) an in-depth exploration of reasons for differences and the potential for consensus.

Results: although published results differed by up to 73% (for statins), standardization of inputs (stage 2) narrowed these gaps. Greater understanding of the reasons for differences was achieved, but a consensus on preferred values for all data inputs was not reached.

Conclusions: we found that published guidance on methods was important to reduce variation in important model inputs. Although the comparison of models did not lead to consensus for all model inputs, it provided a better understanding of the reasons for these differences, and enhanced the transparency and credibility of all models. Similar comparisons would be aided by fuller publication of models, perhaps through detailed web appendices

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e-pub ahead of print date: 5 January 2011
Published date: January 2011
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 181291
URI: http://eprints.soton.ac.uk/id/eprint/181291
ISSN: 1098-3015
PURE UUID: 0537e314-36ea-4840-b876-ae378f4e36db
ORCID for Keith Cooper: ORCID iD orcid.org/0000-0002-0318-7670

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Date deposited: 14 Apr 2011 09:08
Last modified: 15 Mar 2024 03:05

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Contributors

Author: David Turner
Author: James Raftery
Author: Keith Cooper ORCID iD
Author: Eleanor Fairbank
Author: Stephen Palmer
Author: Sue Ward
Author: Roberta Ara

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