THE POTENTIAL OF EARLY MODELING OF NEW TECHNOLOGIES TO HELP INFORM DECISION-MAKING

Purpose: The objective of a publicly-funded health service is to maximise health from the available resources whilst minimising opportunity cost. Decision-makers make judgments about the relative advantages of using a new technology and choices need to be made regarding the alternative uses of health care resources. Economic evaluation can help setting these priorities and allocating resources. We advocate that consideration of economic measures and economic analysis should be incorporated at every level of the development of the evidence-base of a technology. Using a case-study, we postulate that early modeling may help inform decision-making and whether further research will be worthwhile.

Method: Using interventional treatments for snoring we assessed the feasibility of providing effectiveness and cost-effectiveness estimates. Methods included linear exponential models to extrapolate long-term data from primary studies and Markov decision models estimating life time costs and benefits.

Result: It was possible to generate information that allowed extrapolation of outcomes to the longer-term, extend the analysis to relevant comparators and provide a focus for future data collection. Three questions were addressed: -given that decision-makers decide that a treatment for snoring should be offered to patients, which one is worthwhile introducing? -given the available evidence on effectiveness and cost-effectiveness, should decision-makers consider introducing a treatment for snoring? -would further research in this area be worthwhile? Although there were limitations in the evidence-base and uncertainty surrounding the data used, the results are very stable over a range of plausible deterministic and probabilistic sensitivity analyses, meaning that it was possible to provide meaningful information.

Conclusion: Early modeling was possible and potentially useful. Although there is a time commitment associated with this task we will show that for this case-study the cost of conducting this research was worth the effort and we echo arguments that economic evaluations should be conducted ‘early and often’.