ArticleHealth economics review2021
Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney.
Article in Health economics review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Learning From Queues: Operational Analysis and Performance Evaluation of Dialysis Duration in a Paired Kidney Exchange With anLearning health systems · 2026Article
- Spectrum of Models for Assessing the Cost Effectiveness of Total Knee Replacement Implants: A Comparison of Discrete-Time Cohort Markov and Continuous-Time Individual-Level Multistate Models.PharmacoEconomics · 2026Article
- Estimated health outcomes of breast cancer screening in the national breast and cervical cancer early detection program by race/ethnicity.Cancer causes & control : CCC · 2025Article
- Different Models, Same Results: Considerations When Choosing Between Approaches to Model Cost Effectiveness of Chimeric-Antigen Receptor T-Cell Therapy Versus Standard of Care.PharmacoEconomics · 2024Article
- Cost-Effectiveness and Budget Impact Analysis of Implementing a 'Soft Opt-Out' System for Kidney Donation in Australia.Applied health economics and health policy · 2022Article
- The potential of Senolytics in transplantation.Mechanisms of ageing and development · 2021Review
- Real-World Cost-Effectiveness of Late Time Window Thrombectomy for Patients With Ischemic Stroke.Frontiers in neurology · 2021Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEconomic-evaluations using decision analytic models such as Markov-models (MM), and discrete-event-simulations (DES) are high value adds in allocating resources. The choice of modelling method is critical because an inappropriate model yields results that could lead to flawed decision making. The aim of this study was to compare cost-effectiveness when MM and DES were used to model results of transplanting a lower-quality kidney versus remaining waitlisted for a kidney.
methodsCost-effectiveness was assessed using MM and DES. We used parametric survival models to estimate the time-dependent transition probabilities of MM and distribution of time-to-event in DES. MMs were simulated in 12 and 6 monthly cycles, out to five and 20-year time horizon.
resultsDES model output had a close fit to the actual data. Irrespective of the modelling method, the cycle length of MM or the time horizon, transplanting a low-quality kidney as compared to remaining waitlisted was the dominant strategy. However, there were discrepancies in costs, effectiveness and net monetary benefit (NMB) among different modelling methods. The incremental NMB of the MM in the 6-months cycle lengths was a closer fit to the incremental NMB of the DES. The gap in the fit of the two cycle lengths to DES output reduced as the time horizon increased.
conclusionDifferent modelling methods were unlikely to influence the decision to accept a lower quality kidney transplant or remain waitlisted on dialysis. Both models produced similar results when time-dependant transition probabilities are used, most notable with shorter cycle lengths and longer time-horizons.
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