Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, ON, Canada.
Institute of Health Economics, 1200, 10405 Jasper Avenue, Edmonton, AB, T5J 3N4, Canada.
Pharmacoeconomics. 2018 Jan;36(1):7-15. doi: 10.1007/s40273-017-0583-4.
In evaluating new oncology medicines, two common modeling approaches are state transition (e.g., Markov and semi-Markov) and partitioned survival. Partitioned survival models have become more prominent in oncology health technology assessment processes in recent years. Our experience in conducting and evaluating models for economic evaluation has highlighted many important and practical pitfalls. As there is little guidance available on best practices for those who wish to conduct them, we provide guidance in the form of 'Key steps for busy analysts,' who may have very little time and require highly favorable results. Our guidance highlights the continued need for rigorous conduct and transparent reporting of economic evaluations regardless of the modeling approach taken, and the importance of modeling that better reflects reality, which includes better approaches to considering plausibility, estimating relative treatment effects, dealing with post-progression effects, and appropriate characterization of the uncertainty from modeling itself.
在评估新的肿瘤学药物时，有两种常见的建模方法：状态转移（例如，马尔可夫和半马尔可夫）和分割生存。近年来，分割生存模型在肿瘤学卫生技术评估过程中变得更加突出。我们在进行和评估经济评估模型方面的经验突出了许多重要且实际的陷阱。由于那些希望进行这些模型的人几乎没有可用的最佳实践指南，因此我们以“忙碌分析师的关键步骤”的形式提供指导，这些分析师可能时间非常有限，并且需要非常有利的结果。我们的指导强调了无论采用何种建模方法，都需要严格进行经济评估并进行透明报告，以及建模更能反映现实的重要性，这包括更好的方法来考虑合理性、估计相对治疗效果、处理进展后效果，以及对建模本身的不确定性进行适当描述。
