Article (Scientific journals)
Development and Validation of a Markov Microsimulation Model for the Economic Evaluation of Treatments in Osteoporosis.
Hiligsmann, Mickaël; Ethgen, Olivier; Bruyère, Olivier et al.
2009In Value in Health, 12 (5), p. 687-696
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Abstract :
[en] ABSTRACT Objective: Markov models are increasingly used in economic evaluations of treatments for osteoporosis. Most of the existing evaluations are cohort-based Markov models missing comprehensive memory management and versatility. In this article, we describe and validate an original Markov microsimulation model to accurately assess the cost-effectiveness of prevention and treatment of osteoporosis. Methods: We developed a Markov microsimulation model with a lifetime horizon and a direct health-care cost perspective. The patient history was recorded and was used in calculations of transition probabilities, utilities, and costs. To test the internal consistency of the model, we carried out an example calculation for alendronate therapy. Then, external consistency was investigated by comparing absolute lifetime risk of fracture estimates with epidemiologic data. Results: For women at age 70 years, with a twofold increase in the fracture risk of the average population, the costs per quality-adjusted life-year gained for alendronate therapy versus no treatment were estimated at Euro 9105 and Euro 15,325, respectively, under full and realistic adherence assumptions. All the sensitivity analyses in terms of model parameters and modeling assumptions were coherent with expected conclusions and absolute lifetime risk of fracture estimates were within the range of previous estimates, which confirmed both internal and external consistency of the model. Conclusion: Microsimulation models present some major advantages over cohort-based models, increasing the reliability of the results and being largely compatible with the existing state of the art, evidence-based literature. The developed model appears to be a valid model for use in economic evaluations in osteoporosis.
Disciplines :
Rheumatology
Special economic topics (health, labor, transportation...)
Author, co-author :
Hiligsmann, Mickaël ;  Université de Liège - ULiège > HEC - École de gestion de l'ULiège > Economie industrielle
Ethgen, Olivier ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiques
Bruyère, Olivier  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique - Département des sciences de la santé publique
Richy, Florent;  Université de Liège - ULiège > HEC - École de gestion de l'ULiège > Economie générale et gestion publique
Gathon, Henry-Jean ;  Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Reginster, Jean-Yves  
Language :
English
Title :
Development and Validation of a Markov Microsimulation Model for the Economic Evaluation of Treatments in Osteoporosis.
Publication date :
2009
Journal title :
Value in Health
ISSN :
1098-3015
eISSN :
1524-4733
Publisher :
Blackwell Publishing, Oxford, United Kingdom
Volume :
12
Issue :
5
Pages :
687-696
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 June 2009

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