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A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus

Author

Listed:
  • Marina Antoniou

    (Lancaster University)

  • Céu Mateus

    (Lancaster University)

  • Bruce Hollingsworth

    (Lancaster University)

  • Andrew Titman

    (Lancaster University)

Abstract

Background Diabetes mellitus is a chronic and complex disease, increasing in prevalence and consequent health expenditure. Cost-effectiveness models with long time horizons are commonly used to perform economic evaluations of diabetes’ treatments. As such, prediction accuracy and structural uncertainty are important features in cost-effectiveness models of chronic conditions. Objectives The aim of this systematic review is to identify and review published cost-effectiveness models of diabetes treatments developed between 2011 and 2022 regarding their methodological characteristics. Further, it also appraises the quality of the methods used, and discusses opportunities for further methodological research. Methods A systematic literature review was conducted in MEDLINE and Embase to identify peer-reviewed papers reporting cost-effectiveness models of diabetes treatments, with time horizons of more than 5 years, published in English between 1 January 2011 and 31 of December 2022. Screening, full-text inclusion, data extraction, quality assessment and data synthesis using narrative synthesis were performed. The Philips checklist was used for quality assessment of the included studies. The study was registered in PROSPERO (CRD42021248999). Results The literature search identified 30 studies presenting 29 unique cost-effectiveness models of type 1 and/or type 2 diabetes treatments. The review identified 26 type 2 diabetes mellitus (T2DM) models, 3 type 1 DM (T1DM) models and one model for both types of diabetes. Fifteen models were patient-level models, whereas 14 were at cohort level. Parameter uncertainty was assessed thoroughly in most of the models, whereas structural uncertainty was seldom addressed. All the models where validation was conducted performed well. The methodological quality of the models with respect to structure was high, whereas with respect to data modelling it was moderate. Conclusions Models developed in the past 12 years for health economic evaluations of diabetes treatments are of high-quality and make use of advanced methods. However, further developments are needed to improve the statistical modelling component of cost-effectiveness models and to provide better assessment of structural uncertainty.

Suggested Citation

  • Marina Antoniou & Céu Mateus & Bruce Hollingsworth & Andrew Titman, 2024. "A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus," PharmacoEconomics, Springer, vol. 42(1), pages 19-40, January.
    • Handle: RePEc:spr:pharme:v:42:y:2024:i:1:d:10.1007_s40273-023-01312-4
    DOI: 10.1007/s40273-023-01312-4
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    References listed on IDEAS

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    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    2. Helen A. Dakin & José Leal & Andrew Briggs & Philip Clarke & Rury R. Holman & Alastair Gray, 2020. "Accurately Reflecting Uncertainty When Using Patient-Level Simulation Models to Extrapolate Clinical Trial Data," Medical Decision Making, , vol. 40(4), pages 460-473, May.
    3. M. Brisson & W. J. Edmunds, 2006. "Impact of Model, Methodological, and Parameter Uncertainty in the Economic Analysis of Vaccination Programs," Medical Decision Making, , vol. 26(5), pages 434-446, September.
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