Drug Evaluation Committee Cost-Effectiveness Analysis Using Patient-Level Models
Data Science Subcommittee
December 2019
The 2019 DS Subcommittee Continuation T5 aims to outline the abstracts of Technical Support Documents (TSDs) published by the Decision Support Unit of NICE, UK, and to introduce the details of statistical methods.
In April of this year, cost-effectiveness assessment was institutionalized as a complementary system to the existing drug price standard system. The designation of items to be covered by the system is carried out at the same time as new drugs are listed on the insurance market. Under this system, a company analysis is conducted after pre-analysis consultations regarding analysis methods, etc., and a comprehensive evaluation is made by a specialized organization for cost-effectiveness evaluation, and the usefulness-based additional portion of the drug price is adjusted based on the incremental cost-effectiveness ratio (ICER). The ICER obtained through cost-effectiveness analysis is calculated by dividing the incremental public health care costs of a new drug treatment and a control treatment by the difference in quality-adjusted life years (QALYs) as a measure of usefulness. Economic models are used to estimate healthcare costs and QALYs, including population-level models such as so-called Markov models and decision tree models, as well as patient-level models that simulate and summarize each patient in the target population. Compared to population-level models, there are few explanations in Japanese dealing with patient-level models. Based on Technical Support Document 15 COST-EFFECTIVENESS MODELLING USING PATIENT-LEVEL SIMULATION (2014) published by NICE in the U.K., we have now developed a model of what a patient-level model looks like. This presentation will include an implementation by SAS (porting the Excel/R model of TSD 15). We hope this will be of interest to readers interested in patient-level models. Please note that the references/references to TSD 15 in this report are the interpretation of this Task Force and NICE is not responsible for any of them. In addition, not all of TSD 15 has been introduced, but some excerpts have been extracted and introduced. In introducing them, the Task Force has developed and introduced additional interpretations and SAS programs. Please note that these are the Task Force's own interpretations, and have not been taken as the views of NICE.
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