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A Systematic Review of Model-Based Economic Evaluations of Treatments for Venous Leg Ulcers


  • Ashley Layer

    (University of East Anglia)

  • Emma McManus

    (University of East Anglia)

  • N. J. Levell

    (Norfolk and Norwich University Hospitals NHS Foundation Trust)


Objective The aim of this review was to identify, and assess the quality of, published model-based economic evaluations relating to treatments for patients with venous leg ulcers to help inform future decision-analytic models in this clinical area. Methods A systematic literature search was performed on six electronic databases, from database inception until 21 May 2018. Search results were screened against predefined criteria by two independent reviewers. Data was then extracted from the included studies using a standardised form, whilst the decision-analytic model-specific Philips Checklist was used to assess quality and to inform model critique. Results A total of 23 models were identified, 12 studies used a Markov modelling approach, five used decision trees and six studies did not detail the model type. Studies were predominantly from the National Health Service (NHS)/payer perspective, with only two taking a societal perspective. Interventions were wide ranging, but dressing technologies (11/23) were most common. The intervention studied was found to be dominant in 22/23 studies. The reporting quality of papers was mostly low, with evidence behind model structures, time horizons and data selection consistently underreported across the included papers. Conclusions This review has identified a sizeable literature of model-based economic evaluations, evaluating treatments for venous leg ulcers. However, the methods used to conduct such studies were generally poorly reported. In particular, the reporting of evidence surrounding the model structure, justification of the time horizon used and the rationale for selecting data inputs should be focused on in any future models developed.

Suggested Citation

  • Ashley Layer & Emma McManus & N. J. Levell, 2020. "A Systematic Review of Model-Based Economic Evaluations of Treatments for Venous Leg Ulcers," PharmacoEconomics - Open, Springer, vol. 4(2), pages 211-222, June.
  • Handle: RePEc:spr:pharmo:v:4:y:2020:i:2:d:10.1007_s41669-019-0148-x
    DOI: 10.1007/s41669-019-0148-x

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    References listed on IDEAS

    1. (Various), 2008. "Book Reviews," The Energy Journal, International Association for Energy Economics, vol. 0(Number 1), pages 173-179.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    3. World Health Organisation (WHO), 2015. "World Report on Ageing and Health," Working Papers id:7816, eSocialSciences.
    4. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    6. Qinglu Cheng & Nicholas Graves & Rosana E. Pacella, 2018. "Economic Evaluations of Guideline-Based Care for Chronic Wounds: a Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 16(5), pages 633-651, October.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 1st June 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-06-01 11:00:00

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