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Type: Journal article
Title: A critical review of model-based economic studies of depression: modelling techniques, model structure and data sources
Author: Hajiali Afzali, H.
Karnon, J.
Gray, J.
Citation: Pharmacoeconomics, 2012; 30(6):461-482
Publisher: Adis International Ltd
Issue Date: 2012
ISSN: 1170-7690
Statement of
Hossein Haji Ali Afzali, Jonathan Karnon and Jodi Gray
Abstract: Depression is the most common mental health disorder and is recognized as a chronic disease characterized by multiple acute episodes/relapses. Although modelling techniques play an increasingly important role in the economic evaluation of depression interventions, comparatively little attention has been paid to issues around modelling studies with a focus on potential biases. This, however, is important as different modelling approaches, variations in model structure and input parameters may produce different results, and hence different policy decisions. This paper presents a critical review of literature on recently published model-based cost-utility studies of depression. Taking depression as an illustrative example, through this review, we discuss a number of specific issues in relation to the use of decision-analytic models including the type of modelling techniques, structure of models and data sources. The potential benefits and limitations of each modelling technique are discussed and factors influencing the choice of modelling techniques are addressed. This review found that model-based studies of depression used various simulation techniques. We note that a discrete-event simulation may be the preferred technique for the economic evaluation of depression due to the greater flexibility with respect to handling time compared with other individual-based modelling techniques. Considering prognosis and management of depression, the structure of the reviewed models are discussed. We argue that a few reviewed models did not include some important structural aspects such as the possibility of relapse or the increased risk of suicide in patients with depression. Finally, the appropriateness of data sources used to estimate input parameters with a focus on transition probabilities is addressed. We argue that the above issues can potentially bias results and reduce the comparability of economic evaluations.
Keywords: Humans; Models, Economic; Markov Chains; Depressive Disorder, Major; Bias (Epidemiology); Decision Support Techniques; Decision Trees; Cost-Benefit Analysis; Policy Making
Rights: © Springer, Part of Springer Science+Business Media
RMID: 0020118966
DOI: 10.2165/11590500-000000000-00000
Appears in Collections:Public Health publications

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