Posted: October 3rd, 2022

HSH 764 Economic Evaluation: Theory and Practice

HSH 764 Economic Evaluation: Theory and Practice
Assessment Task 3 – Data analysis, reporting and interpretation
2,000 word Max
Use Harvard referencing style.
Antidepressant medication to prevent depression relapse
Depression causes emotional distress and interfere daily function of the individuals. There are also impact on their families and society. National income can be reduced by 4% associated with depression from an increased unemployment, increased sick days, reduced productivity and increase welfare expenditure. It has been estimated that >300 million people live with depression worldwide.
Antidepression can be used as a first-line treatment of depressive symptoms, maintenance treatment, and prevent relapse once an individual has recovered. Long-term maintenance antidepressant treatment has been increasing in practice. However, evidence of the health and economic benefits of the maintenance treatment beyond 8 months is limited.
You, a health economist at the EconoMax® Ltd., has been approached to conduct a cost-utility analysis of alongside a randomised control trial. The parallel, double-blinded, multisite, pragmatic trial recruited 100 participants in total from Australian States & Territories. Participants are aged 18-65 years who ad experienced at least 2 episodes of depression. Participants were taking one of the four most used antidepressant medications – Citalopram, Sertraline, Fluoxetine, and Mirtazapine. At the point of recruitment, participants were well enough to consider stopping their medication. They were ineligible to take part the trail if they had bipolar disorder, psychotic illness, dementia or terminal illness, could not understand questionnaires in English, had contraindication to the medication or placebo ingredients, were taking monoamine oxidase inhibitor or was participant of other clinical trial. Pregnant, planning pregnancy women and breastfeeding were excluded. At the time they were recruited, the people in the study were healthy enough to think about stopping their medication. They were not allowed to take part in the trial if they had bipolar disorder, psychotic illness, dementia, or a terminal illness, if they couldn’t understand the English questionnaires, if they were allergic to the medicine or placebo ingredients, if they were taking a monoamine oxidase inhibitor, or if they had already taken part in another clinical trial. Women who were pregnant, planning to get pregnant, or nursing were not allowed.
The trial compares efficacy of the continuing maintenance antidepressant (Intervention) and discontinuing (Control). While participants in the intervention continued taking their medication, participants in the control took placebo.
Health resource use, medications and self-reported SF-12 questionnaires were administered at baseline, 3, 6, 9 and 12 months. Resource use questionnaire were administered at 6- and 12-months asking service uptake in the past 6 months. Days absent from paid work was collected at baseline and every 3 months thereafter. The attached data file contains collected information from each participant as well as unit costs.
Your task is to analyse the data provided and interpret it for a decision maker – the Pharmaceutical Benefits Advisory Committee
1. Calculate the average costs for each group from a “health care” and “societal” perspective from the provided dataset. (10 points)
2. Calculate the average QALYs for each group. (5 points)
3. Calculate the average incremental cost/QALY from perspectives using your results from 1 and 2. (5 points)
4. Calculate the average net monetary benefit from the above results using the WTP threshold for a QALY gain of $50,000 from both perspectives. (5 points)
5. Using the Briggs bootstrap macro in Excel to bootstrap your ICER results 1000 times. Construct a cost-effectiveness plane and an acceptability curve. Interpret cost-effectiveness plane graphs using the $50K per QALY threshold and interpret acceptability curve. (10 points)
6. Calculate and interpret confidence intervals of ICERs from both perspectives. (10 points)
7. What recommendation you would like to make for the Pharmaceutical Benefit Advisory Committee based on your findings? (30 points)
8. Describe strengths and limitations of this economic evaluation alongside a trial. And suggest how we can improve the robustness of this cost-utility study. (10 points)
9. Do you think you need more information for this CUA? If no, please explain. If yes, what do information you would like to suggest? (10 points)
5 points for presentation, grammar and spelling, and citation.

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