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首页> 外文期刊>Rheumatology >An overview of models used in economic analyses of biologic therapies for arthritis--from current diversity to future consensus.
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An overview of models used in economic analyses of biologic therapies for arthritis--from current diversity to future consensus.

机译：从目前的多样性到未来的共识，对用于关节炎的生物疗法进行经济分析的模型概述。

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摘要

A number of cost-effectiveness models have been developed with the aim of providing guidance for decision making on biologic therapies for the management of inflammatory joint disease. The findings of these analyses can differ markedly, and these differences can undermine the credibility of such models if unexplained. To allow differences between models to be identified more easily, we define six components common to all models-initial response, longer term disease progression, mortality, quality-adjusted life year estimation, resource use and the selection and interpretation of data. We give examples of divergent approaches taken by model structures to the same issue, and explore the impact of divergence on model results, with particular focus on two models that have reported substantially different estimates for the cost-effectiveness of third-line etanercept vs conventional DMARD. The sensitivity of results to a particular assumption made in a model will depend on the decision problem and assumptions made elsewhere in the model, highlighting the importance of guidance throughout model development. To some extent, guidance from bodies such as the National Institute of Health and Clinical Excellence can be used to determine which approach should be preferred where models differ. However, there is a pressing need for clinical input and guidance before consensus can be reached on the most credible model(s) to use for decision support.
机译：已经开发了许多成本效益模型，其目的是为炎症性关节疾病的治疗的生物疗法决策提供指导。这些分析的发现可能会有显着差异，并且如果无法解释，这些差异可能会破坏此类模型的可信度。为了更容易识别模型之间的差异，我们定义了所有模型共有的六个组成部分-初始响应，长期疾病进展，死亡率，经质量调整的生命年估计，资源使用以及数据的选择和解释。我们提供了模型结构对同一问题采取不同方法的示例，并探讨了差异对模型结果的影响，特别关注两个报告了三线依那西普与传统DMARD成本效益估算存在明显差异的模型。结果对模型中特定假设的敏感性将取决于决策问题和模型中其他地方的假设，从而突出了整个模型开发过程中指导的重要性。在某种程度上，可以使用诸如美国国立卫生与临床研究所等机构的指南来确定在模型不同时应采用哪种方法。然而，在就最可靠的模型用于决策支持达成共识之前，迫切需要临床投入和指导。

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