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Are adverse effects incorporated in economic models? A survey of current practice

Published online by Cambridge University Press:  29 June 2010

Dawn Craig ,
Catriona McDaid ,
Tiago Fonseca ,
Christian Stock ,
Steven Duffy  and
Nerys Woolacott
Dawn Craig
Affiliation:
University of York
Catriona McDaid
Affiliation:
University of York
Tiago Fonseca
Affiliation:
University of York
Christian Stock
Affiliation:
University of York
Steven Duffy
Affiliation:
University of York
Nerys Woolacott
Affiliation:
University of York
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Abstract

Background: Clearly the benefits of a treatment must not be outweighed by the adverse effects. If researchers fail to incorporate adverse effects adequately in models, this could limit the validity of the results obtained. In the worst case, interventions that are cost-effective may be shown not to be. The aim of this research was to review current practice when incorporating adverse effects in economic models.

Methods: A survey of HTA reports commissioned by the National Institute for Health Research (NIHR) Health Technology Assessment programme, published between 2004 and 2007 was conducted. All reports which investigated the clinical and cost-effectiveness of a health technology using a systematic review and an economic model framework were included.

Results: A total of eighty reports met the inclusion criteria. Of the models including adverse effects (43/80), 67 percent used a clinical adverse effects parameter, 79 percent a cost of adverse effects parameter, 86 percent used one of these, and 60 percent used both. Of the thirty-seven models that did not include adverse effects, eighteen justified this omission, most commonly lack of data; nineteen appeared to make no explicit consideration of adverse effects in the model.

Conclusions: In many cases, poor reporting made it difficult to ascertain if there had been any consideration of adverse effects. We suggest that the findings of this survey support a call for much clearer and explicit reporting of adverse effects, or their exclusion, in decision models and for explicit recognition in future guidelines that “all relevant outcomes” should include some consideration of adverse events.

Keywords

Adverse effects/eventsEconomic modelsDecision modelingDecision analytic modelsCost-effectiveness analysisHealth technology assessment research
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 3 , July 2010 , pp. 323 - 329
Copyright
Copyright © Cambridge University Press 2010

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