Centre for Health Economic Research 8th Annual Mini-Course

When the Centre for Health Economic Research's annual mini-course with a focus on health economic evaluation was launched, there was great interest. Over 100 people from across five countries had signed up. The main attraction? Professor Andrew Briggs, a world-leading researcher in health economic evaluations.

Uppsala and the Blåsenhus campus showed their best side in the May sun when the participants for HEFUU's annual mini-course arrived on 24 May. The atmosphere was great and expectations high. The theme of this year's course was: "The State of Health Economic Modelling: Integrating statistical and decision modeling for better reimbursement decision making." The topic attracted audiences from academia. authorities as well as industry from several countries.

"HEFUU is an interdisciplinary forum and the goal of our courses is to create a common basis for methods of health economic analysis both inside and outside the academy," says director Erik Grönqvist.

The course leader Andrew Briggs, professor of health economics at the London School of Hygiene & Tropical Medicine and co-director of the Global Health Economics Center at the same university, is a world leader in the field. His research focuses primarily on statistical methods for cost-effectiveness analysis and he has written the books Decision Modeling for Health Economics Evaluation and Statistical Methods for Cost-Effectiveness Analysis, which are classics in the industry. The goal of the course was to provide an overview of the latest modeling techniques to support health economic evaluations. In addition, the course provided practical examples for those who would like to create models after the course.

"We are very proud to present such an outstanding researcher as Andrew Briggs. We look forward to learning more about the latest in modeling and health economic evaluations, as do our participants. The interest in the course has been great: all places were booked in four days," says Erika Grönqvist.

Föreståndare Erik Grönqvist med professor Andrew Briggs

Director Erik Grönqvist with professor Andrew Briggs

Instructor:
Andrew Briggs, Professor of Health Economic, London School of Hygiene & Tropical Medicine

Objective:
To discuss the latest developments in modelling techniques to support health economic evaluation and to signpost resources for those wishing to develop their modelling skills.

Description:
It is common to find in the literature the distinction between trial-based and model-based health economic evaluations. Increasingly, the lines between these approaches have become blurred and most economic evaluation would now be better characterized as a hybrid approach with decision modelling providing the framework for the analysis and models parameterized using a mix of primary (subject-level) and secondary (aggregate) data sources. Even where a single, often randomized, study forms the basis of an evaluation, formal modelling of the data is often required and, in any case, offers advantages over simple by-arm comparisons of cost-effectiveness. In this short course, the state-of-the art for health economic evaluation methods will be covered to include the basics of model building. The focus will be on the functionality of the model to facilitate more sophisticated analyses and better decision making. Examples will be used throughout the course and publicly available practical exercises will be signposted for participants that want to develop their technical skills in model building, either in Excel or in R.

Kursschema:

Dag 1

09.00 – 10.30

A brief history of health economic evaluation and decision modelling

  • What is health economic evaluation?
  • Whither trial-based analysis?
  • Whither model-based analysis?

10.30 – 11.00

Paus

11.00 – 12.30

Value frameworks and the evolution of NICE decision making

  • UK NICE: Vanguard of HTA methods or plotting a course to destruction?
  • Augmented CEA & the Value Flower
  • Is MCDA ready for Prime Time?

12.30 – 13.30

Lunch

13.30 – 15.00

The economics of diagnosis

  • Expected value of perfect diagnostic information
  • Expected value of clinical information
  • ROC curves on the CE plane

15.00 – 15.30

Paus

15.30 – 17.00

Advanced Markov Modelling: the case of Total Hip Replacement

  • Lifetable modelling
  • Survival modelling
  • Functional parameter and heterogeneity

Dag 2

09.00 – 10.30

Probabilistic modelling and the presentation of heterogeneity/uncertainty

  • Distributions for common model parameters
  • Correlating parameters
  • Multiple CEACs

10.30 – 11.00

Paus

11.00 – 12.30

Value of information

  • Expected value of perfect information (EVPI)
  • Expected value of sample information (EVSI)
  • Expected net benefits of sampling (ENBS)

12.30 – 13.30

Lunch

13.30 – 15.00

Value attribution of combination therapies

  • Not cost-effective at zero price paradox
  • Perfect information value attribution
  • Imperfect information value attribution

15.00 – 15.30

Paus

15.30 – 17.00

Individualized cost-effectiveness and pricing strategies

  • EUROPA trial/model
  • Demand curve from individualized cost-effectiveness
  • Monopoly pricing

Kurslitteratur:

Briggs A, Sculpher M, Claxton K. Decision Modelling for Health Economic Evaluation. Oxford: OUP, 2006.

Briggs A, Mihaylova B, Sculpher M, Hall A, Wolstenholme J, Simoons M, Deckers J, Ferrari R, Remme WJ, Bertrand M, Fox K; EUROPA Trial Investigators. Cost effectiveness of perindopril in reducing cardiovascular events in patients with stable coronary artery disease using data from the EUROPA study. Heart. 2007;93(9):1081-6. http://dx.doi.org/10.1136/hrt.2005.086728. PMID: 17135223

Briggs A, Sculpher M, Dawson J, Fitzpatrick R, Murray D, Malchau H. The use of probabilistic decision models in technology assessment : the case of total hip replacement. Appl Health Econ Health Policy. 2004;3(2):79-89. https://doi.org/10.2165/00148365-200403020-00004. PMID: 15702945

Briggs AH, Doyle A, Schneider , Taylor H, Roffe , Low E, Davis S, Kaiser M, Hatswell A, Rabin N, Podkonjak T. An Attribution of Value Framework Combination Therapies. Takeda White Paper. 2021. Published online: https://www.takeda.com/en-gb/what-we-do/combination-treatments/

Laking G, Lord J, Fischer A. The economics of diagnosis. Health Econ. 2006;15(10):1109-20. https://doi.org/10.1002/hec.1114. PMID: 16652389

Phelps CE, Mushlin AI. Focusing technology assessment using medical decision theory. Med Decis Making. 1988;8(4):279-89. https://doi.org/10.1177/0272989X8800800409. PMID: 3185180

Sculpher MJ, Claxton K, Drummond M, McCabe C. Whither trial-based economic evaluation for health care decision making? Health Econ. 2006;15(7):677-87. https://doi.org/10.1002/hec.1093. PMID: 16491461

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