The use of a Markov Cost-Effectiveness Analysis and a PRO Instrument to Inform and Evaluate the Clinical and Economic Value of Drug Interventions

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Communicating complex health economics & outcomes research (HEOR) evidence is key to inform policy decision makers on the clinical and economic implication of drug interventions. Using a Markov Cost-Effectiveness Analysis and a PRO Instrument, this paper will attempt to describe how HEOR information can be used to inform healthcare decision-making process. In fact, multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system in which the immune system causes damage to the myelin sheath, leading to an inflammatory response and various neurological symptoms. While the economic evaluation of MS is often assessed using the EQ-5D, alternative disease-specific instruments and sources of utility values, can also be used. This analysis recreated and assessed the cost-effectiveness of a MS injection drug through an Excel-based Markov base case analysis, using the Expanded Disability Status Scale (EDSS) health states. Results show that the ICER for subcutaneous Glatiramer Acetate (GA) vs. symptom management is $6,5080.33 per quality-adjusted life-year (QALY) gained, which means that glatiramer acetate may be more costly than symptom management but could be as effective as symptom management.

Osteoporosis is a common skeletal disease that presents with reduced bone strength and increased risk of fractures that are associated with high healthcare costs. Treatments for osteoporosis with bisphosphonates have been shown to increase bone strength and reduce fracture risk. This project aimed to answer the following research question: “Do women ≥ 50 years with osteoporosis and history of fracture who receive ibandronate 3 mg injection every three months have improved yearly physical functioning compared to those receiving ibandronate 150 mg oral tablet once monthly?” Results showed that the OPAQ-PF can assess the physical burden of osteoporosis and the effectiveness of therapeutic interventions for this disease. However, the content validity of this instrument may not necessarily reflect the perspectives of other races.



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