The cost-effectiveness of long-acting reversible contraceptive methods in the UK: analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline

Introduction. Individuals from older populations tend to have more than 1 health condition (multimorbidity). Current approaches to produce economic evidence for clinical guidelines using decision-analytic models typically use a single-disease approach, which may not appropriately reflect the competing risks within a population with multimorbidity. This study aims to demonstrate a proof-of-concept method of modeling multiple conditions in a single decision-analytic model to estimate the impact of multimorbidity on the cost-effectiveness of interventions. Methods. Multiple conditions were modeled within a single decision-analytic model by linking multiple single-disease models. Individual discrete event simulation models were developed to evaluate the cost-effectiveness of preventative interventions for a case study assuming a UK National Health Service perspective. The case study used 3 diseases (heart disease, Alzheimer’s disease, and osteoporosis) that were combined within a single linked model. The linked model, with and without correlations between diseases incorporated, simulated the general population aged 45 years and older to compare results in terms of lifetime costs and quality-adjusted life-years (QALYs). Results. The estimated incremental costs and QALYs for health care interventions differed when 3 diseases were modeled simultaneously (£840; 0.234 QALYs) compared with aggregated results from 3 single-disease models (£408; 0.280QALYs). With correlations between diseases additionally incorporated, both absolute and incremental costs and QALY estimates changed in different directions, suggesting that the inclusion of correlations can alter model results. Discussion. Linking multiple single-disease models provides a methodological option for decision analysts who undertake research on populations with multimorbidity. It also has potential for wider applications in informing decisions on commissioning of health care services and long-term priority setting across diseases and health care programs through providing potentially more accurate estimations of the relative cost-effectiveness of interventions.

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Policy ahead of clinical practice: a qualitative study of implementation experiences in states with Medicaid coverage of immediate postpartum long-acting reversible contraceptive methods

Contraception ◽

10.1016/j.contraception.2015.06.097 ◽

2015 ◽

Vol 92 (4) ◽

pp. 377

Author(s):

M. Moniz ◽

T. Chang ◽

M. Davis ◽

J. Forman ◽

J. Landgraff ◽

...

Keyword(s):

Clinical Practice ◽

Qualitative Study ◽

Contraceptive Methods ◽

Medicaid Coverage ◽

Long Acting ◽

Long Acting Reversible Contraceptive

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The Cost-Effectiveness of a Novel SIAscopic Diagnostic Aid for the Management of Pigmented Skin Lesions in Primary Care: A Decision-Analytic Model

Value in Health ◽

10.1016/j.jval.2012.12.008 ◽

2013 ◽

Vol 16 (2) ◽

pp. 356-366 ◽

Cited By ~ 15

Author(s):

Edward C.F. Wilson ◽

Jon D. Emery ◽

Ann Louise Kinmonth ◽

A. Toby Prevost ◽

Helen C. Morris ◽

...

Keyword(s):

Primary Care ◽

Cost Effectiveness ◽

Skin Lesions ◽

Decision Analytic Model ◽

Analytic Model ◽

Diagnostic Aid ◽

Pigmented Skin Lesions ◽

The Cost

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PES2 A DECISION-ANALYTIC MODEL TO COMPARE THE COST OF METHYL AMINOLEVULINATE PHOTODYNAMIC THERAPY WITH STANDARD TREATMENTS IN THE UK FOR DIFFICULT-TO-TREAT BASAL CELL CARCINOMA AND ACTINIC KERATOSIS

Value in Health ◽

10.1016/s1098-3015(10)61112-6 ◽

2002 ◽

Vol 5 (3) ◽

pp. 245-246

Author(s):

M Aristides ◽

D Tilden ◽

P Robinson ◽

A Weston ◽

P Davey ◽

...

Keyword(s):

Photodynamic Therapy ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Actinic Keratosis ◽

Decision Analytic Model ◽

Analytic Model ◽

Methyl Aminolevulinate ◽

The Uk ◽

The Cost

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A decision analytic model to investigate the cost-effectiveness of poisoning prevention practices in households with young children

BMC Public Health ◽

10.1186/s12889-016-3334-0 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Felix Achana ◽

Alex J. Sutton ◽

Denise Kendrick ◽

Mike Hayes ◽

David R. Jones ◽

...

Keyword(s):

Cost Effectiveness ◽

Young Children ◽

Decision Analytic Model ◽

Analytic Model ◽

The Cost ◽

Poisoning Prevention

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Cost-Effectiveness of Pharmacological Interventions for Smoking Cessation: A Literature Review and a Decision Analytic Analysis

Medical Decision Making ◽

10.1177/027298902237708 ◽

2002 ◽

Vol 22 (1_suppl) ◽

pp. 26-37 ◽

Cited By ~ 73

Author(s):

Fujian Song ◽

James Raftery ◽

Paul Aveyard ◽

Chris Hyde ◽

Pelham Barton ◽

...

Keyword(s):

Smoking Cessation ◽

Cost Effectiveness ◽

Cost Effective ◽

Decision Analytic Model ◽

Relative Cost ◽

Pharmacological Interventions ◽

Relative Cost Effectiveness ◽

Life Years ◽

The Uk ◽

The Cost

To evaluate the relative cost-effectiveness of nicotine replacement therapy (NRT) and bupropion SR for smoking cessation, the authors reviewed published studies and developed a decision analytic model from the UK National Health Services perspective. Irrespective of the methods or assumptions involved, the results of published studies consistently indicated that NRT for smoking cessation is cost-effective. No published studies have evaluated the relative cost-effectiveness of bupropion SR for smoking cessation. The results of the decision analyses indicated that, as compared with advice or counseling alone, the incremental cost per life-years saved is about $1,441~$3,455 for NRT, $920~$2,150 for bupropion SR, and $1,282~$2,836 for NRT plus bupropion SR. The cost-effectiveness of adding NRT and bupropion SR to advice or counseling for smoking cessation is better than many other accepted health care interventions.

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