Biomedical Engineering Reference
In-Depth Information
28.2
COLLABORATIONS IN HEALTH ECONOMICS MODELING
The observations described above are also true for the health economics com-
munity where models built to analyze comparative effectiveness or cost-
effectiveness are maintained in the developers' silos, rather than being made
available to all potential stakeholders—policy makers, investigators, develop-
ers, industry sponsors, academicians, health authorities, and others charged
with making decisions based on these models. Can we overcome the propri-
etary and technological challenges that might reduce the feasibility and desir-
ability to use the “cloud” and other advances to enhance our future
opportunities for collaboration?
Health economics and comparative-effectiveness questions are being
increasingly answered using computational models in the hands of the stake-
holders who have to make decisions using them [7]. With limited health care
dollars, exploding health care costs, and confusion about which strategies
result in the best patient outcomes, computerized models can help to objectify
the complexities of comparative effectiveness and cost-effectiveness of differ-
ent therapeutic options to aid in decision making by pharmaceutical/device
manufacturers, health authorities, and health care practitioners regarding
therapeutic guidelines, reimbursement/coverage, and overall patient health.
Indeed, computational models are used to answer many questions such as
determining therapy/market advancement/characterization [8, 9] through
postmarketing surveillance [10, 11] and budget impact and policy decisions.
Countless examples in other areas of health care demonstrate the enormous
importance of modeling studies. However, there is an inherent complexity in
modeling health care decisions and the relative isolation under which the work
of modeling is often carried out; this likely needs to be overcome [12-15].
Many of these published models are developed using readily accessible com-
mercial software; however, there is no way to easily share such computer-based
models across organizations and make them available for reuse in the public
domain to interested parties. Various researchers [16-18] and organizations
have called for transparency and availability of models, “reused” with different
data, and continually revised as new information becomes available. It has
been proposed that what is needed is the creation of a collaborative Web-
based tool [tentatively called Economic Collaborative for Health Outcomes
(ECHO)] that would serve as a means to store and share health care models,
allowing for the proprietary nature of some of these [19]. This could enable
disparate modelers to create higher quality products by being more collabora-
tive and sharing models and techniques. It would also provide a dynamic
resource for interacting online with some of the thousands of published models
so they would remain in use for a longer period [19] and shifting incrementally
as more data are made available.
As stated above, potential challenges may include those of price, confi den-
tiality, quality assurance, and overcoming the silo mentality of modelers. Price
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