A Bayesian Microsimulation Approach to Health Economic Evaluation in Schizophrenia Treatment Algorithms and Lifetime Colorectal Cancer Screening

• Activity Number: 478
• Type: Invited
• Date/Time: Wednesday, August 6, 2014 : 10:30 AM to 12:20 PM
• Sponsor: Section on Bayesian Statistical Science
• Author(s): Vanja Dukic and Yolanda Hagar*+ and Anirban Basu and Herbert Y. Meltzer
• Companies: University of Colorado at Boulder and University of Colorado at Boulder and University of Washington and Northwestern University
• Keywords: Bayesian microsimulation ; health economics ; schizophrenia ; colorectal cancer ; screening ; treatment algorithms

Abstract

We obtain the posterior predictive distribution of transition probabilities between symptom severity states over time for patients with schizophrenia by (i) employing a Bayesian meta-analysis of published clinical trials and observational studies to estimate the posterior distribution of parameters that guide changes in Positive and Negative Syndrome Scale (PANSS) scores over time and under the influence of various drugs and (ii) by propagating the variability from the posterior distributions of the parameters through a micro-simulation model that is formulated based on schizophrenia progression. Results show detailed differences among treatment methods in controlling various levels of severities over time. These details may further serve to better estimate quality of life of patients and aid in resource utilization decisions in treating schizophrenic patients. In addition, the uncertainty in the time-profile parameters has important implications for the practice of cost-effectiveness analysis and for future resource allocation policy in treatment of schizophrenia. We also discuss an extension to the model for lifetime patterns in colorectal cancer screening behavior.