Communicating the parameter uncertainty in the IQWiG efficiency frontier to decision-makers

Stollenwerk, B., Lhachimi, S. K., Briggs, A. , Fenwick, E., Caro, J. J., Siebert, U., Danner, M. and Gerber-Grote, A. (2015) Communicating the parameter uncertainty in the IQWiG efficiency frontier to decision-makers. Health Economics, 24(4), pp. 481-490. (doi: 10.1002/hec.3041) (PMID:24590819)


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The Institute for Quality and Efficiency in Health Care (IQWiG) developed—in a consultation process with an international expert panel—the efficiency frontier (EF) approach to satisfy a range of legal requirements for economic evaluation in Germany's statutory health insurance system. The EF approach is distinctly different from other health economic approaches. Here, we evaluate established tools for assessing and communicating parameter uncertainty in terms of their applicability to the EF approach. Among these are tools that perform the following: (i) graphically display overall uncertainty within the IQWiG EF (scatter plots, confidence bands, and contour plots) and (ii) communicate the uncertainty around the reimbursable price. We found that, within the EF approach, most established plots were not always easy to interpret. Hence, we propose the use of price reimbursement acceptability curves—a modification of the well-known cost-effectiveness acceptability curves. Furthermore, it emerges that the net monetary benefit allows an intuitive interpretation of parameter uncertainty within the EF approach. This research closes a gap for handling uncertainty in the economic evaluation approach of the IQWiG methods when using the EF. However, the precise consequences of uncertainty when determining prices are yet to be defined.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Fenwick, Professor Elisabeth and Briggs, Professor Andrew
Authors: Stollenwerk, B., Lhachimi, S. K., Briggs, A., Fenwick, E., Caro, J. J., Siebert, U., Danner, M., and Gerber-Grote, A.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
Journal Name:Health Economics
Publisher:John Wiley & Sons
ISSN (Online):1099-1050
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Health Economics 24(4):481-490
Publisher Policy:Reproduced under a Creative Commons License

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