Advanced Search
MyIDEAS: Login

Comprehensive Decision-Analytic Model and Bayesian Value-of-Information Analysis: Pentoxifylline in the Treatment of Chronic Venous Leg Ulcers

Contents:

Author Info

  • Cynthia P. Iglesias

    (Department of Health Sciences, University of York, York, UK
    Centre for Health Economics, University of York, York, UK)

  • Karl Claxton

    (Centre for Health Economics, University of York, York, UK
    Department of Economics and Related Studies, University of York, York, UK)

Abstract

Objective: To conduct a Bayesian value-of-information analysis of the cost effectiveness of pentoxifylline (vs placebo) as an adjunct to compression for venous leg ulcers. Methods: A probabilistic Markov model was developed to estimate mean clinical benefits and costs associated with oral pentoxifylline (400mg three times daily) and placebo. Clinical data were obtained from a systematic review and synthesised using Bayesian methods. The decision uncertainty associated with the adoption of pentoxifylline as well as the maximum value associated with further research were estimated before and after the completion of the largest `definitive' treatment trial. Resource use was obtained from a UK national audit and unit costs applied (Lstg , 2004 values). Results: The prior and posterior analyses suggest that pentoxifylline is a dominant therapy versus placebo. In the prior analysis, patients in the pentoxifylline group healed an average of 8.28 weeks quicker than patients in the placebo group (95% credibility interval [CI] 1.89, 14.56), had a 0.02 gain in QALYs (95% CI -0.12, 0.17) and an average reduction in cost of Lstg 153.4 (95% CI -53.11, 354.9). Estimates of the uncertainty surrounding the cost effectiveness of pentoxifylline and the value of perfect information in both analyses did not suggest further research was justified. In the prior analysis, for willingness-to-pay values of Lstg 0, Lstg 100 and Lstg 500 per QALY gained, the estimated values of perfect information were Lstg 128_200, Lstg 127_100 and Lstg 126_700, respectively. Incorporation of the information from the largest randomised controlled trial on pentoxifylline did improve the estimate of the clinical effect associated with this drug; however, the variation was not large enough to reverse either the decision regarding the dominance of pentoxifylline or the maximum value associated with further research. Conclusion: Bayesian value-of-information analysis represents a valuable tool for healthcare decision making. Had the results from this analysis been available before the largest trial was funded, a more efficient allocation of research and development resources could have been made.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
File URL: http://pharmacoeconomics.adisonline.com/pt/re/phe/pdfhandler.00019053-200624050-00005.pdf
Download Restriction: Pay per view

File URL: http://pharmacoeconomics.adisonline.com/pt/re/phe/fulltext.00019053-200624050-00005.htm
Download Restriction: Pay per view

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Bibliographic Info

Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

Volume (Year): 24 (2006)
Issue (Month): 5 ()
Pages: 465-478

as in new window
Handle: RePEc:wkh:phecon:v:24:y:2006:i:5:p:465-478

Contact details of provider:
Web page: http://pharmacoeconomics.adisonline.com/

Related research

Keywords: Cost-effectiveness; Cost-utility; Pentoxifylline; Value-of-information-analysis; Varicose-ulcer;

Find related papers by JEL classification:

References

No references listed on IDEAS
You can help add them by filling out this form.

Citations

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:wkh:phecon:v:24:y:2006:i:5:p:465-478. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin).

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.