IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v31y2022is1p116-134.html
   My bibliography  Save this article

An approach to quantify parameter uncertainty in early assessment of novel health technologies

Author

Listed:
  • Rowan Iskandar
  • Carlo Federici
  • Cassandra Berns
  • Carl Rudolf Blankart

Abstract

Health economic modeling of novel technology at the early stages of a product lifecycle has been used to identify technologies that are likely to be cost‐effective. Such early assessments are challenging due to the potentially limited amount of data. Modelers typically conduct uncertainty analyses to evaluate their effect on decision‐relevant outcomes. Current approaches, however, are limited in their scope of application and imposes an unverifiable assumption, that is, uncertainty can be precisely represented by a probability distribution. In the absence of reliable data, an approach that uses the fewest number of assumptions is desirable. This study introduces a generalized approach for quantifying parameter uncertainty, that is, probability bound analysis (PBA), that does not require a precise specification of a probability distribution in the context of early‐stage health economic modeling. We introduce the concept of a probability box (p‐box) as a measure of uncertainty without necessitating a precise probability distribution. We provide formulas for a p‐box given data on summary statistics of a parameter. We describe an approach to propagate p‐boxes into a model and provide step‐by‐step guidance on how to implement PBA. We conduct a case and examine the differences between the status‐quo and PBA approaches and their potential implications on decision‐making.

Suggested Citation

  • Rowan Iskandar & Carlo Federici & Cassandra Berns & Carl Rudolf Blankart, 2022. "An approach to quantify parameter uncertainty in early assessment of novel health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 116-134, September.
  • Handle: RePEc:wly:hlthec:v:31:y:2022:i:s1:p:116-134
    DOI: 10.1002/hec.4525
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4525
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4525?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Joke Bilcke & Philippe Beutels & Marc Brisson & Mark Jit, 2011. "Accounting for Methodological, Structural, and Parameter Uncertainty in Decision-Analytic Models," Medical Decision Making, , vol. 31(4), pages 675-692, July.
    2. Maarten J. IJzerman & Hendrik Koffijberg & Elisabeth Fenwick & Murray Krahn, 2017. "Emerging Use of Early Health Technology Assessment in Medical Product Development: A Scoping Review of the Literature," PharmacoEconomics, Springer, vol. 35(7), pages 727-740, July.
    3. Jordana K. Schmier & Jasmine D. Patel & Megan J. Leonhard & Prem A. Midha, 2019. "A Systematic Review of Cost-Effectiveness Analyses of Left Ventricular Assist Devices: Issues and Challenges," Applied Health Economics and Health Policy, Springer, vol. 17(1), pages 35-46, February.
    4. Maarten Ijzerman & Lotte Steuten, 2011. "Early assessment of medical technologies to inform product development and market access," Applied Health Economics and Health Policy, Springer, vol. 9(5), pages 331-347, September.
    5. Grabowski, Henry & Mullins, C. Daniel, 1997. "Pharmacy benefit management, cost-effectiveness analysis and drug formulary decisions," Social Science & Medicine, Elsevier, vol. 45(4), pages 535-544, August.
    6. Peter Doubilet & Colin B. Begg & Milton C. Weinstein & Peter Braun & Barbara J. McNeil, 1985. "Probabilistic Sensitivity Analysis Using Monte Carlo Simulation," Medical Decision Making, , vol. 5(2), pages 157-177, June.
    7. Claire McKenna & Karl Claxton, 2011. "Addressing Adoption and Research Design Decisions Simultaneously," Medical Decision Making, , vol. 31(6), pages 853-865, November.
    8. Bogdan Grigore & Oriana Ciani & Florian Dams & Carlo Federici & Saskia Groot & Meilin Möllenkamp & Stefan Rabbe & Kosta Shatrov & Antal Zemplenyi & Rod S. Taylor, 2020. "Surrogate Endpoints in Health Technology Assessment: An International Review of Methodological Guidelines," PharmacoEconomics, Springer, vol. 38(10), pages 1055-1070, October.
    9. Fuchs, Sabine & Olberg, Britta & Panteli, Dimitra & Perleth, Matthias & Busse, Reinhard, 2017. "HTA of medical devices: Challenges and ideas for the future from a European perspective," Health Policy, Elsevier, vol. 121(3), pages 215-229.
    10. Andrew H. Briggs & Milton C. Weinstein & Elisabeth A. L. Fenwick & Jonathan Karnon & Mark J. Sculpher & A. David Paltiel, 2012. "Model Parameter Estimation and Uncertainty Analysis," Medical Decision Making, , vol. 32(5), pages 722-732, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Karl Claxton & Elisabeth Fenwick & Mark J. Sculpher, 2012. "Decision-making with Uncertainty: The Value of Information," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 51, Edward Elgar Publishing.
    2. Hester V Eeren & Saskia J Schawo & Ron H J Scholte & Jan J V Busschbach & Leona Hakkaart, 2015. "Value of Information Analysis Applied to the Economic Evaluation of Interventions Aimed at Reducing Juvenile Delinquency: An Illustration," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-15, July.
    3. Wang, Yi & Rattanavipapong, Waranya & Teerawattananon, Yot, 2021. "Using health technology assessment to set priority, inform target product profiles, and design clinical study for health innovation," Technological Forecasting and Social Change, Elsevier, vol. 172(C).
    4. Michael Drummond & Carlo Federici & Vivian Reckers‐Droog & Aleksandra Torbica & Carl Rudolf Blankart & Oriana Ciani & Zoltán Kaló & Sándor Kovács & Werner Brouwer, 2022. "Coverage with evidence development for medical devices in Europe: Can practice meet theory?," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 179-194, September.
    5. Carlo Federici & Leandro Pecchia, 2022. "Exploring the misalignment on the value of further research between payers and manufacturers. A case study on a novel total artificial heart," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 98-115, September.
    6. Stefania Manetti & Emanuele Lettieri & Melody Zhifang Ni, 2023. "Development and validation of Medical Device Key Evidence Tool (‘MeDKET’): An evidence-based framework to explain success in selected European and US companies," PLOS ONE, Public Library of Science, vol. 18(7), pages 1-13, July.
    7. Florian Methling & Steffen A. Borden & Deepak Veeraraghavan & Insa Sommer & Johannes Ulrich Siebert & Rüdiger von Nitzsch & Mark Seidler, 2022. "Supporting Innovation in Early-Stage Pharmaceutical Development Decisions," Decision Analysis, INFORMS, vol. 19(4), pages 337-353, December.
    8. Fuchs, Sabine & Olberg, Britta & Perleth, Matthias & Busse, Reinhard & Panteli, Dimitra, 2019. "Testing a new taxonomic model for the assessment of medical devices: Is it plausible and applicable? Insights from HTA reports and interviews with HTA institutions in Europe," Health Policy, Elsevier, vol. 123(2), pages 173-181.
    9. Ezbakhe, Fatine & Pérez-Foguet, Agustí, 2021. "Decision analysis for sustainable development: The case of renewable energy planning under uncertainty," European Journal of Operational Research, Elsevier, vol. 291(2), pages 601-613.
    10. Samir S Soneji & Hai-Yen Sung & Brian A Primack & John P Pierce & James D Sargent, 2018. "Quantifying population-level health benefits and harms of e-cigarette use in the United States," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-19, March.
    11. Malek B Hannouf & Chander Sehgal & Jeffrey Q Cao & Joseph D Mocanu & Eric Winquist & Gregory S Zaric, 2012. "Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-9, June.
    12. Matteo Richiardi & Ross E. Richardson, 2017. "JAS-mine: A new platform for microsimulation and agent-based modelling," International Journal of Microsimulation, International Microsimulation Association, vol. 10(1), pages 106-134.
    13. Elisa Sicuri & Silke Fernandes & Eusebio Macete & Raquel González & Ghyslain Mombo-Ngoma & Achille Massougbodgi & Salim Abdulla & August Kuwawenaruwa & Abraham Katana & Meghna Desai & Michel Cot & Mic, 2015. "Economic Evaluation of an Alternative Drug to Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-23, April.
    14. Jordan Amdahl & Jose Diaz & Arati Sharma & Jinhee Park & David Chandiwana & Thomas E Delea, 2017. "Cost-effectiveness of pazopanib versus sunitinib for metastatic renal cell carcinoma in the United Kingdom," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-18, June.
    15. Naveed Chehrazi & Lauren E. Cipriano & Eva A. Enns, 2019. "Dynamics of Drug Resistance: Optimal Control of an Infectious Disease," Operations Research, INFORMS, vol. 67(3), pages 619-650, May.
    16. Carlo Lazzaro, 2025. "Letter to the Editor: Lazzaro responds to Kennedy et al," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(1), pages 141-142, February.
    17. Carus, Jana & Heuner, Maike & Paul, Maike & Schröder, Boris, 2017. "Which factors and processes drive the spatio-temporal dynamics of brackish marshes?—Insights from development and parameterisation of a mechanistic vegetation model," Ecological Modelling, Elsevier, vol. 363(C), pages 122-136.
    18. Qiao Liu & Chongqing Tan & Lidan Yi & Xiaomin Wan & Liubao Peng & Jianhe Li & Xia Luo & Xiaohui Zeng, 2021. "Cost-effectiveness analysis of pembrolizumab plus chemotherapy as first-line therapy for extensive-stage small-cell lung cancer," PLOS ONE, Public Library of Science, vol. 16(11), pages 1-13, November.
    19. Oriana Ciani & Bogdan Grigore & Rod S. Taylor, 2022. "Development of a framework and decision tool for the evaluation of health technologies based on surrogate endpoint evidence," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 44-72, September.
    20. Nadia Yakhelef & Martine Audibert & Gabriella Ferlazzo & Joseph Sitienei & Steve Wanjala & Francis Varaine & Maryline Bonnet & Helena Huerga, 2020. "Cost-effectiveness of diagnostic algorithms including lateral-flow urine lipoarabinomannan for HIV-positive patients with symptoms of tuberculosis," Post-Print halshs-03170014, HAL.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:31:y:2022:i:s1:p:116-134. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.