How NOT to develop a health economic model

By Dr Shehzad Ali and Tushar Srivastava

Concluded on 21 July 2022

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A health economic model is a critical piece of evidence considered by health technology assessment (HTA) agencies globally to inform reimbursement decisions. These models use explicit decision frameworks and robust evidence on multiple parameters to identify the most cost-effective strategy to provide value for money for public investment.

The process of developing health economic models can be complex, and require model developers to make a number of decisions regarding model structure, comparators, model parameters, statistical approaches and modelling assumptions. These choices occur at every stage of the model development process. Failure to account for important complexities of the decision problem correctly may result in the development of models which can be contextually naïve, error-prone or non-useful for decision making.

More often than not, HTA agencies identify challenges in the economic models submitted for reimbursement. These challenges may be methodological or structural; as a result, models may not appropriately reflect the disease process, current scientific evidence and/or the population or the decision-making context. These modelling issues have the potential to alter the final reimbursement recommendations.

We reviewed > 50 pharmacoeconomic reports published by CADTH and NICE based on their critical review of economic models submitted for drug reimbursement in Canada and the UK. We identified, classified and critically appraised the key methodological challenges identified in the economic models submitted by manufacturers. We particularly focused on modeling choices considered questionable by the review committees and were subsequently evaluated in their reanalysis to re-estimate cost-effectiveness estimates.

In this webinar, we discuss common problems with models submitted to HTA agencies, their impact on cost-effectiveness estimates, and practical strategies to avoid or overcome these challenges. In short, we discuss how not to model. We also discuss the role and steps in model validation process for early identification of issues with economic models.

You will benefit most from this webinar if you are one of the following:

 

  1. Developing or reviewing health economic models
  2. Supervising a team who deals with health economics or health economic modeling
  3. Interested in understanding the key areas considered by HTA agencies in their review process
  4. Member of or involved with stakeholders in the HTA review process (such as submitting manufacturers, review groups, review committee)

Dr Shehzad Ali

MBBS, MPH, MSc (MStats), PhD
Canada Research Chair, Public Health Economics

Department of Epidemiology and Biostatistics
Schulich School of Medicine & Dentistry, Western University

Visiting Associate Professor, Macquarie University, Australia

Dr Ali has over 15 years of professional experience as an academic researcher and consultant in the public and private sectors in both developed and developing countries. Dr. Ali is the Canada Research Chair in Public Health Economics, Department of Epidemiology and Biostatistics, and cross-appointed with the Western Centre for Public Health and Family Medicine, Western University. He is Visiting Associate Professor of Health Economics at University of York (UK).

His expertise include HTA, decision modelling  Estimating the treatment effect of interventions using real world evidence; Monitoring and benchmarking health service performance in terms of efficiency and equity of access, utilisation and outcomes using large patient-level administrative data, explaining heterogeneity in health outcomes and predicting events using individual patient-level data and Eliciting value judgments and treatment preferences to inform resource allocation decisions.

Tushar Srivastava

MSc (Statistics and Computing)
Director – Modeling and Analytics, ConnectHEOR, UK
Fellow, Royal Statistical Society, UK
Honorary Research Fellow, ScHARR, University of Sheffield, UK

Endorsed as a ‘Global Talent’ by prestigious ‘The Royal Society, UK’, Tushar is dynamic and  enjoys approaching complex problems with a holistic approach. He also holds an MSc. in Statistics and has authored a handbook on higher Mathematics, “A concise handbook of vector space theory and field theory, Srivastava T.”

Tushar’s technical expertise lies in different techniques including cost-effectiveness modelling, budget impact modelling, simulation modelling, statistical modelling and indirect comparisons analysis. He brings a unique blend of academic research, technical modelling and statistical skills and industry professionalism to support the life science industry at every stage of the product life cycle. He has a good experience in statistical analyses, including survival analysis and health related quality of life data analysis from clinical trials.

Tushar has worked in multiple  disease areas including oncology, CVD, infectious diseases, rare-diseases such as Fabry disease, ulcerative colitis, Crohn’s disease, and multiple sclerosis. He has extensive experience of product launch in countries in Europe, the United States, Latin America, and Australia. He also holds an Academic Researcher position in ScHARR, University of Sheffield, UK.

Besides work, Tushar enjoys playing badminton, jogging, and meditating.

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    Judit Banhazi

    Specialty
    Value and Access

    Role
    Vice President

    Degree
    MD Medicine, JD Law

    Judit Banhazi

    MD Medicine, JD Law

    Judit Banhazi, based in Basel, Switzerland, brings over 20 years of experience in HEOR, Market Access, and Health Policy.
    She has led HEOR strategies in hematology and initiated EU HTA policy activities. Judit began her career as a physician and has worked at prime global pharma companies. Her academic prowess is excellent with a peculiar combination of an MD in Medicine and a JD in Law, she has been at forefront of health economics by being involved in HTA policy discussions with EFPIA and HTAi.
    Known for her collaborative spirit and practical approach, Judit is passionate about learning and delivering quality work. Outside of work, she enjoys spending time with family and friends, travelling, and running.

    Adam Ball

    Specialty
    Business Development Manager

     

    Adam Ball

    Business Manager

    I am delighted to be part of the team here at ConnectHEOR. To tell you a bit about me, I have 10 years experience within Talent Acquisition within HEOR, RWE and Market Access. I have built a global network during this time and am excited to utilize this to help us grow as business. 

     

    Outside of work I love sports, playing football and squash regularly, as well as going to the gym. I also enjoy watching sports mainly football and tennis. I have a new born daughter too so she is taking up a lot of my time and is a bundle of joy. I also play drums and like to think I have a broad taste in Music.

     

    Eleni Tente

    Specialty
    Medical writing, Evidence planning

    Role
    Consultant, Medical writer

    Degree
    PhD – Molecular biology and genetics

    Eleni Tente

    PhD – Molecular biology and genetics

    Eleni Tente is an experienced medical writer with proven ability to translate complex scientific information into clear, concise, and impactful content to diverse audiences. She has a strong background in integrated evidence planning, publications, internal communications and e-learning development, complemented by an understanding of various therapeutic areas.

    Eleni holds a PhD in molecular biology and genetics from the University of Cambridge and an MSc in plant genetic manipulation from the University of Nottingham.

    In her free time, Eleni enjoys diving into a good book, fishing along the coast, or planning her next thrilling scuba diving adventure to swim with sharks.

    Syed Salleh

    Specialty
    HTA Modelling and Discrete-event Simulation

    Role
    Consultant, Modeling & Analytics

    Degree
    PhD – Health & Related Research

    Syed Salleh

    PhD. Health & Related Research

    Syed Salleh brings extensive experience in HTA modeling, having successfully led the development of both de novo and adaptation models for HTA listings across multiple countries, including Malaysia, Philippines, and the UK. His work spans key therapeutic franchises such as oncology, cardiometabolic, and respiratory. Syed has also delivered critical insights to healthcare professionals through MYSPOR, ITTP, and IKN virtual CME events and numerous publications.

    He holds a PhD in Health and Related Research from the School of Health and Related Research (ScHARR) at the University of Sheffield, UK, with a specialization in HTA and operational research, specifically in discrete-event simulation (DES) technique.

    During his time in a leading pharmaceutical company, Syed played a key role in securing the listing of several key products in the Malaysia Ministry of Health Formulary and served as the primary contact for DES-related projects.

    Besides work, Syed enjoys traveling, listening to music, and spending quality time with his family.

    Thai-Son Tong

    Specialty
    Model Conceptualization and Data Analytics

    Role
    Senior Consultant

    Degree
    PhD – Health Economics

    Thai-Son Tong

    PhD. Health Economics

    Thaison Tong has extensive work experience in health economics, decision modelling and big data analysis. He has a unique mix of experience in HEOR and RWE related research in academia and pharmaceutical industry. His expertise lies in health technology assessments (HTA), health economic modelling, simulation modelling, big data analytics and decision analysis. He has hands-on experience in a range of software and programming languages including R, R Shiny, R Markdown, Python, MS Excel, VBA, and Simul8. He has substantial experience of the health care system in the UK and other European countries.

    Thaison has direct experience in building cost-effectiveness models from scratch and conducting big data analysis in several disease areas including dementia, vascular disease, and cancer.

    Thaison’s PhD focus was to develop a de novo patient level model for the evaluation of different cognitive screening tests for early detection of dementia and mild cognitive impairment in primary care. He also looked at different methods for conducting economic evaluation in health care taking a broader/societal perspective. In addition, he investigated the use of Multiple Criteria Decision Analysis (MCDA) for economic evaluation.

    Thaison also holds Academic Researcher position in School of Health and Related Research (ScHARR), University of Sheffield, UK and Honorary Researcher position in University of Bristol, UK.

    Thaison’s likes to meditate, and play badminton, basketball and tennis.

    Shilpi Swami

    Specialty
    Consulting and strategy

    Role
    Vice President

    Degree
    MSc. International Economics

    Shilpi Swami

    MSc. International Economics

    Shilpi Swami is a seasoned Health Economics and Outcomes Research (HEOR) expert with experience spanning across multiple healthcare systems and therapy areas. At her current role of Vice President, HTA and Strategy, ConnectHEOR, she provides technical and strategic leadership. Additionally, Shilpi serves as the Member Engagement Co-Chair at ISPOR Oncology Special Interest Group.

    Shilpi has a comprehensive track record of leading HTA submissions and devising market access strategies on a global scale, including the EU-5, Canada, US, Latin America, Australia, and Asia. Shilpi has worked across various sectors within health economics, including academia, consulting, and biopharma. This multidimensional experience equips her with a unique ability to offer strategic insights from various stakeholders’ perspectives.

    Formerly a Research Fellow at the University of York, Shilpi has made significant contributions to public health projects and the development of best practices in the academic side of health economics. In her professional endeavors, she remains dedicated to improving healthcare through data-driven insights and evidence-based research

    Hugo Pedder

    Specialty Statistical Analysis and Evidence Synthesis

    Role Senior Consultant

    Degree PhD – Statistical Modelling

    Hugo Pedder

    PhD – Statistical Modelling

    Hugo brings in a wealth of experience to ConnectHEOR from his extensive work in academia, focusing primarily on evidence synthesis and meta-analysis. Hugo holds PhD in Statistical Modelling from University of Briston and MSc in Medical Statistics from the London School of Hygiene and Tropical Medicine, and his background in neuroscience remains a passionate interest. Alongside working with ConnectHEOR, Hugo continues to part of NICE committee. His expertise includes advanced indirect treatment comparisons technique and has extensive experience of working with the NICE in UK. 

    Beyond professional endeavors, Hugo is an enthusiastic outdoor adventurer, particularly enjoying mountain activities, climbing and ski mountaineering. From building rafts to exploring rivers in north of Sweden, he has lived an adventurous life outside of work and plans to continue to do so.

    Kunal Hriday

    Specialty
    Data science and Strategy

    Role
    Senior Consultant

    Degree
    MSc. Quantitative Economics

    Kunal Hriday

    MSc. Quantitative Economics

    Kunal Hriday is a business strategy and data science professional with experience in helping organizations crack through notorious business challenges. Kunal is proficient in business analytics, data analytics, product lifecycle management and business development. Working as a Data analytics consultant he has spent time in problem solving across variety of industries including Banking, logistics and Health and is now fully dedicated to HEOR. Kunal has hands on experience in various statistical programming tools and languages like R, Python, SAS, Excel VBA, Data Robot and data visualization tools like Power BI, Tableau and SAS VA.

    Kunal also holds a Masters in Quantitative Economics from Indian Statistical Institute and a bachelors degree in Business Economics. Excellent in business communication, he is passionate about studying environmental economics and related theories of welfare optimization.

    Raju Gautam

    Specialty
    Evidence Review

    Role
    Principal Consultant

    Degree
    PhD (Pharmacy)

    Raju Gautam

    PhD Pharmacy

    Raju Gautam spearheads evidence review at ConnectHEOR and  has extensive work experience in evidence review and synthesis, value communications, scientific publications, medical writing and project management.
    His expertise lies in systematic and targeted literature reviews, meta-analyses, network meta-analyses, value communications (AMCP and Global Value Dossiers), RWE study design and publications (manuscripts, posters, and abstracts).
    He has experience working in Global pharma companies, consulting and CRO environment for several therapy areas including Cardiovascular, Oncology, Neurology, Respiratory, Ophthalmic, Rare Diseases, and Vaccines. He has more than 40 publications in international journals as an author.
    Raju also likes jogging, yoga and meditation.

    Radha Sharma

    Specialty:
    Patient preference research, survey, In-depth interviews, COA, Evidence review and conceptualisation of study

    Role:
    Director – Patient-Centered Outcomes Research

    Degree:
    MBBS (Bachelor of Medicine and Bachelor of Surgery), PhD (Global Public Health) – University of York

    Radha Sharma

    PhD (Global Public Health)

    Radha Sharma spearheads Patient-Centered Outcomes Research at ConnectHEOR. She has a background in medicine, public health, and epidemiology.

    Her expertise includes global health research, preference elicitation, mixed-method studies, consensus workshops, qualitative health research, epidemiological analysis of big data sets, RWE study design, scientific writing, and literature reviews. Her primary focus is integrating patient perspectives into all stages of health technology assessment (HTA) and healthcare decision-making processes.

    Her extensive expertise in mixed-method studies and active patient/stakeholder engagement ensures that her research is methodologically rigorous and patient-centric. Radha is an avid hiker and enjoys exploring the beautiful Canadian Rockies.

    Kate Ren

    Specialty
    Statistical Analysis and Evidence Synthesis

    Role
    Director of Statistics

    Degree
    Ph.D Probability and Statistics

    Kate Ren

    PhD Probability and Statistics

    Kate spearheads Statistics and Evidence Synthesis at ConnectHEOR. She has more than 10 years of experience in conducting statistical analysis in HTA. Kate has PhD in Probability and Statistics specialising in Bayesian methods in clinical trial design.

    She specializes in Bayesian methods in health economics and the elicitation of experts’ beliefs and has extensive experience of conducting evidence synthesis, including, meta-analysis, network meta-analysis, MAIC, STC, ML-NMR etc. Besides working with ConnectHEOR, she is also a part of NICE Committee and University of Sheffield.

    Tushar Srivastava

    Specialty
    Decision Modelling and AI Initiatives

    Role
    Director and Principal Consultant

    Degree
    MSc – Statistics and Computing

    Tushar Srivastava

    MSc – Statistics and Computing

    Endorsed as a ‘Global Talent’ by prestigious ‘The Royal Society, UK’, Tushar is dynamic and enjoys approaching complex problems with a holistic approach. He also holds an MSc. in Statistics and has authored a handbook on higher Mathematics, “A concise handbook of vector space theory and field theory, Srivastava T.”

    In ConnectHEOR, Tushar spearhead all HEOR activities.

    Tushar’s technical expertise lies in different techniques including cost-effectiveness modelling, budget impact modelling, simulation modelling, statistical modelling and indirect comparisons analysis. He brings a unique blend of academic research, technical modelling and statistical skills and industry professionalism to support the life science industry at every stage of the product life cycle. He has a good experience in statistical analyses, including survival analysis and health related quality of life data analysis from clinical trials.

    Besides work, Tushar enjoys playing badminton, jogging, and meditating.