Using health economic models to help guide healthcare decisions

Abstract

This editorial accompanies a research article being published by Clinical Medical Research and Opinion (CMRO) journal, entitled "Methods applied in cost-effectiveness models for treatment strategies in type 2 diabetes mellitus and their use in Health Technology Assessments: a systematic review of the literature from 2008 to 2013". The importance and the contribution of this research to the scientific community are presented on the grounds of serving the decision-making process of evaluating and approving T2DM treatments for public funding.

Keywords: :

• Diabetes
• Health economics
• Model
• Qualitative assessment
• Systematic literature review

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder of multiple etiologies. For many years the principal pharmaco-therapeutic options for T2DM were metformin, sulfonylurea and insulin. However, over the last 15 years and continuing today, many alternative treatments have been introduced, resulting in new drug classes each with multiple agents (for example: thiazolidinediones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 agonists, and sodium-glucose transport-2 inhibitors)1. This constantly evolving treatment landscape, coupled with a lack of long-term studies and/or head-to-head clinical trials, presents significant challenges to healthcare decision makers wishing to evaluate T2DM treatments. Although clinical studies remain the main data source for healthcare decision-making, computer simulation models, in essence a series of mathematical equations combined in a structured framework, are required to provide information on long-term clinical and economic outcomes. Consequently, there have been numerous health economic models developed for this disease to estimate the impact of relative treatment effects on long-term incremental costs and health benefits2.

Clinical Medical Research and Opinion (CMRO) journal has previously published an overview of health economic models developed for type 2 diabetes mellitus (T2DM), research conducted by Yi et al.3. The main objective was to identify and critically appraise cost-effectiveness models developed up to September 2008 to evaluate T2DM treatments and to assess which types of treatment effects they capture.

We recently extended the overview of the health economic models that have been developed for T2DM up to 2013. More precisely, the primary objective of our research was to identify and compare health economic models that were developed to evaluate the cost effectiveness of treatments for T2DM, and their use within health technology assessments (HTAs).

The key contribution of this research, besides completing the overview of available economic models for such a broad disease such as T2DM, is that the identified health economic models were qualitatively assessed using six criteria developed based on technical components, and characteristics related to the disease or the treatments being assessed. Finally, their frequency of application within HTA reports, published literature, and/or major conferences, was determined. We strongly believe that keeping a track of available models developed for T2DM by extending the overview in combination with a qualitative assessment of their technical characteristics is a significant asset to the decision-making process of evaluating and approving T2DM treatments for public funding.

Transparency

Declaration of funding

This editorial was not funded.

Declaration of financial/other relationships

M.C. has disclosed that she was an employee of Pharmerit International at the time of the research.

Acknowledgments

The author has disclosed that she had no outside editorial assistance in preparing this editorial. The author thanks the editors of CMRO and Bram G. Verheggen (Director HEOR, Pharmerit International) for their valuable comments.