Dynamic versus static models in cost-effectiveness analyses of anti-viral drug therapy to mitigate an influenza pandemic.
Identifieur interne : 000868 ( Ncbi/Checkpoint ); précédent : 000867; suivant : 000869Dynamic versus static models in cost-effectiveness analyses of anti-viral drug therapy to mitigate an influenza pandemic.
Auteurs : Anna K. Lugnér [Pays-Bas] ; Sido D. Mylius ; Jacco WallingaSource :
- Health economics [ 1099-1050 ] ; 2010.
Descripteurs français
- KwdFr :
- Analyse coût-bénéfice, Antiviraux (usage thérapeutique), Antiviraux (économie), Arbres de décision, Flambées de maladies (), Flambées de maladies (économie), Grippe humaine (traitement médicamenteux), Grippe humaine (transmission), Grippe humaine (économie), Grippe humaine (épidémiologie), Humains, Modèles économétriques, Oséltamivir (usage thérapeutique), Oséltamivir (économie), Pays-Bas (épidémiologie), Transmission de maladie infectieuse ().
- MESH :
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Grippe humaine, Oséltamivir.
- économie : Antiviraux, Flambées de maladies, Grippe humaine, Oséltamivir.
- épidémiologie : Grippe humaine, Pays-Bas.
- Analyse coût-bénéfice, Arbres de décision, Flambées de maladies, Humains, Modèles économétriques, Transmission de maladie infectieuse.
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Antiviral Agents (economics), Antiviral Agents (therapeutic use), Cost-Benefit Analysis, Decision Trees, Disease Outbreaks (economics), Disease Outbreaks (prevention & control), Disease Transmission, Infectious (prevention & control), Humans, Influenza, Human (drug therapy), Influenza, Human (economics), Influenza, Human (epidemiology), Influenza, Human (transmission), Models, Econometric, Netherlands (epidemiology), Oseltamivir (economics), Oseltamivir (therapeutic use).
- MESH :
- chemical , economics : Antiviral Agents, Oseltamivir.
- chemical , therapeutic use : Antiviral Agents, Oseltamivir.
- geographic , epidemiology : Netherlands.
- drug therapy : Influenza, Human.
- economics : Disease Outbreaks, Influenza, Human.
- epidemiology : Influenza, Human.
- prevention & control : Disease Outbreaks, Disease Transmission, Infectious.
- transmission : Influenza, Human.
- Cost-Benefit Analysis, Decision Trees, Humans, Models, Econometric.
Abstract
Conventional (static) models used in health economics implicitly assume that the probability of disease exposure is constant over time and unaffected by interventions. For transmissible infectious diseases this is not realistic and another class of models is required, so-called dynamic models. This study aims to examine the differences between one dynamic and one static model, estimating the effects of therapeutic treatment with antiviral (AV) drugs during an influenza pandemic in the Netherlands. Specifically, we focus on the sensitivity of the cost-effectiveness ratios to model choice, to the assumed drug coverage, and to the value of several epidemiological factors. Therapeutic use of AV-drugs is cost-effective compared with non-intervention, irrespective of which model approach is chosen. The findings further show that: (1) the cost-effectiveness ratio according to the static model is insensitive to the size of a pandemic, whereas the ratio according to the dynamic model increases with the size of a pandemic; (2) according to the dynamic model, the cost per infection and the life-years gained per treatment are not constant but depend on the proportion of cases that are treated; and (3) the age-specific clinical attack rates affect the sensitivity of cost-effectiveness ratio to model choice.
DOI: 10.1002/hec.1485
PubMed: 19382106
Affiliations:
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pubmed:19382106Le document en format XML
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<front><div type="abstract" xml:lang="en">Conventional (static) models used in health economics implicitly assume that the probability of disease exposure is constant over time and unaffected by interventions. For transmissible infectious diseases this is not realistic and another class of models is required, so-called dynamic models. This study aims to examine the differences between one dynamic and one static model, estimating the effects of therapeutic treatment with antiviral (AV) drugs during an influenza pandemic in the Netherlands. Specifically, we focus on the sensitivity of the cost-effectiveness ratios to model choice, to the assumed drug coverage, and to the value of several epidemiological factors. Therapeutic use of AV-drugs is cost-effective compared with non-intervention, irrespective of which model approach is chosen. The findings further show that: (1) the cost-effectiveness ratio according to the static model is insensitive to the size of a pandemic, whereas the ratio according to the dynamic model increases with the size of a pandemic; (2) according to the dynamic model, the cost per infection and the life-years gained per treatment are not constant but depend on the proportion of cases that are treated; and (3) the age-specific clinical attack rates affect the sensitivity of cost-effectiveness ratio to model choice.</div>
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