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Am Heart J. 2015 Nov;170(5):951-60. doi: 10.1016/j.ahj.2015.08.015. Epub 2015 Aug 20.

Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

Author information

1
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. Electronic address: shelby.reed@duke.edu.
2
Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
3
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
4
Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
5
Duke University School of Nursing, Durham, NC.
6
Catawba Valley Cardiology, Conover, NC.
7
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.
8
Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
9
University of Pennsylvania School of Nursing, Philadelphia, PA.
10
University of Washington, Seattle, WA.

Abstract

BACKGROUND:

Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable.

METHODS:

We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs.

RESULTS:

The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system.

CONCLUSION:

The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure.

PMID:
26542504
PMCID:
PMC4638158
DOI:
10.1016/j.ahj.2015.08.015
[Indexed for MEDLINE]
Free PMC Article

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