Online Program

WITHDRAWN - Using real-world data and multistate modeling to inform a health economic model of late stage prostate cancer (307883)

Lusine Abrahamyan, University Health Network 
Karen Bremner, University Health Network 
Steven M Carcone, Toronto Health Economics and Technology Assessment Collaborative 
Alice Dragomir, McGill University 
Murray Dale Krahn, Toronto Health Economics and Technology Assessment (THETA) Collaborative 
*Nicholas Mitsakakis, Biostatistics Research Unit, University Health Network 
Welson Ryan, Toronto Health Economics and Technology Assessment Collaborative 
Ivan Yanev, McGill University 

Keywords: economic model, real-world data, multistate models, administrative data, prostate cancer

Construction of a health economic model requires the analysis and synthesis of data from multiple sources. We employed a compendium of advanced analytical methods to inform and populate a model for late stage prostate cancer (PC). With an expert panel, we developed a conceptual model of 15 heath states, defined by validated clinical and biochemical indicators. We reviewed the charts of 406 PC patients in Toronto and Montreal, to allocate all observed time from PC diagnosis onwards to health states using a newly developed algorithm and visualization tool. We used descriptive, survival and competing risk analyses, and multi-state models, to describe patients’ pathways through the health states and to estimate transition probabilities and times between health states, in the presence of covariates. Chart review data were linked to administrative data at the Institute for Clinical Evaluative Sciences (ICES) for the estimation of mean costs per 30 days for each health state, using mixed effects gamma regression models with time offset. Our approach may be useful for other research groups attempting to use real world evidence to improve the scientific foundation of health economic models.