Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure

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• 作者：Shelby D. Reed ; PhD^a ; ^b ; ^{shelby.reed@duke.edu" class="auth_mail" title="E-mail the corresponding author} ; Matthew P. Neilson ; PhD^c ; Matthew Gardner ; BS^a ; Yanhong Li ; MD^a ; Andrew H. Briggs ; DPhil^c ; Daniel E. Polsky ; PhD^d ; Felicia L. Graham ; MBA^a ; Margaret T. Bowers ; RN ; MSN^e ; Sara C. Paul ; RN ; DNP ; FNP^f ; Bradi B. Granger ; RN ; PhD^e ; Kevin A. Schulman ; MD^a ; ^b ; David J. Whellan ; MD^g ; Barbara Riegel ; DNSc^h ; Wayne C. Levy ; MDⁱ
• 刊名：American Heart Journal
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：170
• 期：5
• 页码：951-960
• 全文大小：341 K

文摘

Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable.

<h4 id="absSec_2">Methodsh4>

We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs.

<h4 id="absSec_3">Resultsh4>

The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system.

<h4 id="absSec_4">Conclusionh4>

The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure.