Limitations of current evaluation techniques for the cost-effectiveness of treatments

November 10, 2004

Parkinson's disease (PD) is one of the most common neurodegenerative disorders. Pharmaceutical and surgical therapies for PD are available and can alleviate the symptoms and complications. Unfortunately, despite these therapies, the disease relentlessly progresses. A new study in the journal Value in Health presents a detailed overview of the current decision-analytic models used to evaluate the cost-effectiveness of therapeutic options in Parkinson's disease.

Lead author Uwe Siebert notes "this article gives an insight into the different methodological approaches used to estimate the cost-effectiveness of treatments for a chronic progressive disorder. Cost-effectiveness is an important issue in PD as newer therapeutic options are costly." Corresponding author Richard Dodel stresses, "Although each of these studies has its distinct value, most currently available models do not explicitly capture the large spectrum of clinically relevant symptoms that physicians must consider in daily clinical decision making."

This study aims to provide decision analysts and clinicians interested in formal medical decision making with an insight into the structural and methodological approaches used in PD decision modeling, including their strengths and limitations. Studying the long-term effect of treatment on clinical symptoms and health-related quality of life is important in evaluating PD interventions. However, since most clinical trials are short, mathematical models must be used to link the short-term clinical outcomes from clinical trials with evidence for the long-term progression of the disease. PD is particularly complex because of the wide spectrum of PD symptoms and treatment complications, and the lifelong progression of the disease. The authors conclude that decision-analytic modeling is a useful tool in clinical decision-making and the economic evaluation of interventions in PD. It cannot replace clinical studies but rather complements them to better inform physicians and policy makers about the potential long-term effectiveness and costs of new and promising interventions.
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This study is published in Value in Health. Media wishing to receive a PDF of this article please contact medicalnews@bos.blackwellpublishing.net.

About the Authors
Uwe Siebert, MD, MPH, MSc is a Senior Decision Scientist and Clinical Epidemiologist at the Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School. He has an adjunct appointment at the School of Public Health and Epidemiology at the University of Munich. Dr. Siebert is available for questions and interviews and can be reached at usiebert@hsph.harvard.edu.

Richard Dodel, MD, of the Department of Neurology, Friedrich-Wilhelms-University in Bonn, Germany, has provided several Markov and decision-analytic models of Parkinson's disease as a part of this group. He is also available for questions and interviews at richard.dodel@ukb.uni-bonn.de.

About Value in Health
Value in Health is a multidisciplinary peer-reviewed journal reporting on evaluations of medical technologies including pharmaceuticals, biologics, devices, procedures, and other health care interventions. As the official journal of the International Society for Pharmacoeconomics and Outcomes Research, the Journal provides a scientific forum for communicating health economics and outcomes research methods and findings.

About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 550 academic and professional societies. Blackwell publishes over 750 journals and 600 text and reference books annually, across a wide range of academic, medical, and professional subjects.

Blackwell Publishing Ltd.

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