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COMPARISON OF METHODS FOR ESTIMATING CONTEMPORARY COSTS: AN APPLICATION TO LIVER TRANSPLANTATION IN THE UNITED KINGDOM

Part of: Special Collection - Methods

Published online by Cambridge University Press:  22 September 2017

Jeshika Singh  and
Louise Longworth
Jeshika Singh
Affiliation:
Health Economics Research Group, Brunel University London PHMR [email protected]
Louise Longworth
Affiliation:
PHMR Limited
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Abstract

Objectives: Our study addresses the important issue of estimating treatment costs from historical data. It is a problem frequently faced by health technology assessment analysts. We compared four approaches used to estimate current costs when good quality contemporary data are not available using liver transplantation as an example.

Methods: First, the total cost estimates extracted for patients from a cohort study, conducted in the 1990s, were inflated using a published inflation multiplier. Second, resource use estimates from the cohort study were extracted for hepatitis C patients and updated using current unit costs. Third, expert elicitation was carried out to identify changes in clinical practice over time and quantify current resource use. Fourth, routine data on resource use were obtained from National Health Service Blood and Transplant (NHSBT).

Results: The first two methods did not account for changes in clinical practice. Also the first was not specific to hepatitis patients. The use of experts confirmed significant changes in clinical practice. However, the quantification of resource use using experts is challenging as clinical specialists may not have a complete overview of clinical pathway. The NHSBT data are the most accurate reflection of transplantation and posttransplantation phase; however, data were not available for the whole pathway of care. The best estimate of total cost, combining NHSBT data and expert elicitation, is £121,211.

Discussion: Observational data from routine care are potentially the most reliable reflection of current resource use. Efforts should be made to make such data readily available and accessible to researchers. Expert elicitation provided reasonable estimates.

Keywords

Hepatitis CCostLiver transplantationExpert elicitation
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 6 , 2017 , pp. 620 - 628
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. DH. NHS Reference Costs 2012–2013. UK: Department of Health, 2013. https://www.gov.uk/government/publications/nhs-reference-costs-2012-to-2013 (accessed July 21, 2017).Google Scholar
2. Sullivan, W, Payne, K. The appropriate elicitation of expert opinion in economic models. Pharmacoeconomics. 2011;29:455.CrossRefGoogle ScholarPubMed
3. O'Hagan, A, Buck, EC, Daneshkhah, A. Uncertain judgements: Eliciting experts’ probabilities. New York: John Wiley & Sons; 2006.CrossRefGoogle Scholar
4. Soares, MO, Bojke, L, Dumville, J, et al. Methods to elicit experts' beliefs over uncertain quantities: Application to a cost effectiveness transition model of negative pressure wound therapy for severe pressure ulceration. Stat Med. 2011;30:2363–2380.Google Scholar
5. Grieve, R, Roberts, J, Wright, M, et al. Cost effectiveness of interferon alpha or peginterferon alpha with raibavarin for histologically mild chronic hepatitis C. Gut. 2006;55:1332–1338.Google Scholar
6. Dakin, H, Bentley, A, Dusheiko, G. Cost-utility analysis of tenofovir disoproxil fumarate in the treatment of chronic hepatitis B. Value Health. 2010;13:922–933.Google Scholar
7. Warren, E, Wright, A, Jones, B. Cost-effectiveness of telaprevir in patients with genotype 1 hepatitis C in Australia. Value Health. 2014;17:792–800.CrossRefGoogle ScholarPubMed
8. Crossan, C, Tsochatzis, EA, Longworth, L, et al. Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: Systematic review and economic evaluation. Health Technol Assess. 2015;19:1–409.Google Scholar
9. Longworth, L, Young, T, Buxton, MJ, et al. Midterm Cost-effectiveness of the liver transplantation program of England and Wales for three disease groups. Liver Transpl. 2003;9:1295–1307.Google Scholar
10. BNF. British National Formulary: Number 38, September 1999. London: British Medical Association. Royal Pharmaceutical Society of Great Britain; 1999.Google Scholar
11. BNF. British National Formulary. 2014. https://bnf.nice.org.uk/.Google Scholar
12. Stevenson, M, Lloyd-Jones, M, Morgan, MY, Wong, R. Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: A systematic review and economic evaluation. Health Technol Assess. 2012;16:1–174.Google Scholar
13. PSSRU. Unit costs of health & social care 2013. http://www.pssru.ac.uk/project-pages/unit-costs/2013/ (accessed July 21, 2017).Google Scholar
14. Leal, J, Wordsworth, S, Legood, R, Blair, E. Eliciting expert opinion for economic models: An applied example. Value Health. 2007;10: 195–203.Google Scholar
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