Markov modeling for cost-effectiveness using federated health data network

© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association..

OBJECTIVE: To introduce 2 R-packages that facilitate conducting health economics research on OMOP-based data networks, aiming to standardize and improve the reproducibility, transparency, and transferability of health economic models.

MATERIALS AND METHODS: We developed the software tools and demonstrated their utility by replicating a UK-based heart failure data analysis across 5 different international databases from Estonia, Spain, Serbia, and the United States.

RESULTS: We examined treatment trajectories of 47 163 patients. The overall incremental cost-effectiveness ratio (ICER) for telemonitoring relative to standard of care was 57 472 €/QALY. Country-specific ICERs were 60 312 €/QALY in Estonia, 58 096 €/QALY in Spain, 40 372 €/QALY in Serbia, and 90 893 €/QALY in the US, which surpassed the established willingness-to-pay thresholds.

DISCUSSION: Currently, the cost-effectiveness analysis lacks standard tools, is performed in ad-hoc manner, and relies heavily on published information that might not be specific for local circumstances. Published results often exhibit a narrow focus, central to a single site, and provide only partial decision criteria, limiting their generalizability and comprehensive utility.

CONCLUSION: We created 2 R-packages to pioneer cost-effectiveness analysis in OMOP CDM data networks. The first manages state definitions and database interaction, while the second focuses on Markov model learning and profile synthesis. We demonstrated their utility in a multisite heart failure study, comparing telemonitoring and standard care, finding telemonitoring not cost-effective.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Journal of the American Medical Informatics Association : JAMIA - 31(2024), 5 vom: 19. Apr., Seite 1093-1101

Sprache:

Englisch

Beteiligte Personen:

Haug, Markus [VerfasserIn]
Oja, Marek [VerfasserIn]
Pajusalu, Maarja [VerfasserIn]
Mooses, Kerli [VerfasserIn]
Reisberg, Sulev [VerfasserIn]
Vilo, Jaak [VerfasserIn]
Giménez, Antonio Fernández [VerfasserIn]
Falconer, Thomas [VerfasserIn]
Danilović, Ana [VerfasserIn]
Maljkovic, Filip [VerfasserIn]
Dawoud, Dalia [VerfasserIn]
Kolde, Raivo [VerfasserIn]

Links:

Volltext

Themen:

Cost-effectiveness
Journal Article
Markov chains
OHDSI CDM
Observational data
Treatment trajectories

Anmerkungen:

Date Completed 22.04.2024

Date Revised 26.04.2024

published: Print

Citation Status MEDLINE

doi:

10.1093/jamia/ocae044

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369618602