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https://doi.org/10.21256/zhaw-3626| Publication type: | Article in scientific journal |
| Type of review: | Peer review (publication) |
| Title: | Cost recommendation under uncertainty in IQWiG’s efficiency frontier framework |
| Authors: | Corro Ramos, Isaac Lhachimi, Stefan K. Gerber-Grote, Andreas Al, Maiwenn J. |
| DOI: | 10.21256/zhaw-3626 10.1177/0272989X16636856 |
| Published in: | Medical Decision Making |
| Volume(Issue): | 37 |
| Issue: | 2 |
| Page(s): | 162 |
| Pages to: | 172 |
| Issue Date: | 2016 |
| Publisher / Ed. Institution: | Sage |
| ISSN: | 0272-989X 1552-681X |
| Language: | English |
| Subjects: | Decision analysis; Detailed methodology : probabilistic sensitivity analysis; Simulation methods; Antidepressive Agents; Cost-Benefit Analysis; Costs and Cost Analysis; Decision Making; Germany; Human; Models, Econometric; Model, Statistical; Uncertainty |
| Subject (DDC): | 610: Medicine and health 658.4: Executive Management |
| Abstract: | Background: The National Institute for Quality and Efficiency in Health Care (IQWiG) employs an efficiency frontier (EF) framework to facilitate setting maximum reimbursable prices for new interventions. Probabilistic sensitivity analysis (PSA) is used when yes/no reimbursement decisions are sought based on a fixed threshold. In the IQWiG framework, an additional layer of complexity arises as the EF itself may vary its shape in each PSA iteration, and thus the willingness-to-pay, indicated by the EF segments, may vary. Objectives: To explore the practical problems arising when, within the EF approach, maximum reimbursable prices for new interventions are sought through PSA. Methods: When the EF is varied in a PSA, cost recommendations for new interventions may be determined by the mean or the median of the distances between each intervention’s point estimate and each EF. Implications of using these metrics were explored in a simulation study based on the model used by IQWiG to assess the cost-effectiveness of 4 antidepressants. Results. Depending on the metric used, cost recommendations can be contradictory. Recommendations based on the mean can also be inconsistent. Results (median) suggested that costs of duloxetine, venlafaxine, mirtazapine, and bupropion should be decreased by €131, €29, €12, and €99, respectively. These recommendations were implemented and the analysis repeated. New results suggested keeping the costs as they were. The percentage of acceptable PSA outcomes increased 41% on average, and the uncertainty associated to the net health benefit was significantly reduced. Conclusions: The median of the distances between every intervention outcome and every EF is a good proxy for the cost recommendation that would be given should the EF be fixed. Adjusting costs according to the median increased the probability of acceptance and reduced the uncertainty around the net health benefit distribution, resulting in a reduced uncertainty for decision makers. |
| URI: | https://digitalcollection.zhaw.ch/handle/11475/5734 |
| Fulltext version: | Published version |
| License (according to publishing contract): | Licence according to publishing contract |
| Departement: | School of Health Sciences |
| Appears in collections: | Publikationen Gesundheit |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 0272989x16636856.pdf | 1.07 MB | Adobe PDF |  View/Open |
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Corro Ramos, I., Lhachimi, S. K., Gerber-Grote, A., & Al, M. J. (2016). Cost recommendation under uncertainty in IQWiG’s efficiency frontier framework. Medical Decision Making, 37(2), 162–172. https://doi.org/10.21256/zhaw-3626
Corro Ramos, I. et al. (2016) ‘Cost recommendation under uncertainty in IQWiG’s efficiency frontier framework’, Medical Decision Making, 37(2), pp. 162–172. Available at: https://doi.org/10.21256/zhaw-3626.
I. Corro Ramos, S. K. Lhachimi, A. Gerber-Grote, and M. J. Al, “Cost recommendation under uncertainty in IQWiG’s efficiency frontier framework,” Medical Decision Making, vol. 37, no. 2, pp. 162–172, 2016, doi: 10.21256/zhaw-3626.
CORRO RAMOS, Isaac, Stefan K. LHACHIMI, Andreas GERBER-GROTE und Maiwenn J. AL, 2016. Cost recommendation under uncertainty in IQWiG’s efficiency frontier framework. Medical Decision Making. 2016. Bd. 37, Nr. 2, S. 162–172. DOI 10.21256/zhaw-3626
Corro Ramos, Isaac, Stefan K. Lhachimi, Andreas Gerber-Grote, and Maiwenn J. Al. 2016. “Cost Recommendation under Uncertainty in IQWiG’s Efficiency Frontier Framework.” Medical Decision Making 37 (2): 162–72. https://doi.org/10.21256/zhaw-3626.
Corro Ramos, Isaac, et al. “Cost Recommendation under Uncertainty in IQWiG’s Efficiency Frontier Framework.” Medical Decision Making, vol. 37, no. 2, 2016, pp. 162–72, https://doi.org/10.21256/zhaw-3626.
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