Result card

  • ECO6: What are the uncertainties surrounding the costs and economic evaluation(s) of Structured telephone support (STS) for adult patients with chronic heart failure and its comparator, 'usual care' without STS?
English

What are the uncertainties surrounding the costs and economic evaluation(s) of Structured telephone support (STS) for adult patients with chronic heart failure and its comparator, 'usual care' without STS?

Authors: Neill Booth, Taru Haula and Heidi Stuerzlinger (supported by Ingrid Rosian-Schikuta).

Internal reviewers: Matthias Schwenkglenks, Nadine Berndt and Fabio Trimaglio

Acknowledgments: We would like to thank information specialist Jaana Isojärvi (THL, Finland) for development of systematic literature search strategies for the ECO domain, and for performing those searches in the available databases. We would also like to acknowledge her generous contribution in helping to construct a Refworks database and in sourcing numerous published articles for review.

As shown in ECO1, Table 2, only hospitalisation costs were included and other costs such as costs related to the remote monitoring of patients, outpatient visits and drug costs were not considered in the study by Klersy et al. 2011 {1}. In the study by Miller et al. (2009) {3}, the authors provided only an average cost of the STS programme and did not provide the breakdown of the individual cost components {4}. In summary, as noted in ORG8, it is useful to note that the methods of cost calculation vary widely across the studies related to STS {15}.

From the EFF domain and from Pandor et al. (2013) {4} we see that the varied estimates of effectiveness are also based on a variety of methods of calculation ranging from estimates based on a single trial, to those based on network meta-analysis (NMA). As Pandor et al. (2013) note, it is important to consider different approaches to STS separately as they are likely to have different clinical effectiveness and costs associated with them. Therefore, specific approaches to STS would ideally be fully described before estimating the cost-effectiveness of the interventions {4}. In the study by Pandor et al (2013) {4} and Thokala et al (2013) {5} individual patient-level data was not used and no adjustment was made for potential biases arising from study quality of the studies included in the NMA. The study by Miller et al. (2009) {3} mainly uses information from Galbreath et al. 2004 {8}, which is classed in EFF1 as having a high risk of bias, and the potential extent of the effect of structural uncertainty on results is not described. For these reasons, it is not fully possible to assess the effect of parameter and structural uncertainty on the results presented in the three cost-effectiveness studies reviewed here ({1}, {4} and {5}).

Critical
Partially
Booth N, . T Result Card ECO6 In: Booth N, . T Costs and economic evaluation In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=305

References