Peñaloza-Ramos, MC, Jowett, S, Sutton, AJ orcid.org/0000-0001-7008-4770 et al. (2 more authors) (2018) The Importance of Model Structure in the Cost-Effectiveness Analysis of Primary Care Interventions for the Management of Hypertension. Value in Health, 21 (3). pp. 351-363. ISSN 1098-3015
Abstract
Background: Management of hypertension can lead to significant reductions in blood pressure, thereby reducing the risk of cardiovascular disease. Modeling the course of cardiovascular disease is not without complications, and uncertainty surrounding the structure of a model will almost always arise once a choice of a model structure is defined. Objectives: To provide a practical illustration of the impact on the results of cost-effectiveness of changing or adapting model structures in a previously published cost-utility analysis of a primary care intervention for the management of hypertension Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups (TASMIN-SR). Methods: The case study assessed the structural uncertainty arising from model structure and from the exclusion of secondary events. Four alternative model structures were implemented. Long-term cost-effectiveness was estimated and the results compared with those from the TASMIN-SR model. Results: The main cost-effectiveness results obtained in the TASMIN-SR study did not change with the implementation of alternative model structures. Choice of model type was limited to a cohort Markov model, and because of the lack of epidemiological data, only model 4 captured structural uncertainty arising from the exclusion of secondary events in the case study model. Conclusions: The results of this study indicate that the main conclusions drawn from the TASMIN-SR model of cost-effectiveness were robust to changes in model structure and the inclusion of secondary events. Even though one of the models produced results that were different to those of TASMIN-SR, the fact that the main conclusions were identical suggests that a more parsimonious model may have sufficed.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. This is an author produced version of a paper published in Value in Health. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | cardiovascular disease; decision-analytic modeling; hypertension; modeling; structural uncertainty |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Oct 2017 13:38 |
Last Modified: | 19 Oct 2018 00:39 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jval.2017.03.003 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:122922 |