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Madan J, Ades T, Barton P, et al. Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party. Rheumatol Ther. 2015;2(2):113-125doi: 10.1007/s40744-015-0020-0.
Madan, J., Ades, T., Barton, P., Bojke, L., Choy, E., Helliwell, P., Jobanputra, P., Stein, K., Stevens, A., Tosh, J., Verstappen, S., & Wailoo, A. (2015). Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party. Rheumatology and therapy, 2(2), 113-125. https://doi.org/10.1007/s40744-015-0020-0
Madan, Jason, et al. "Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party." Rheumatology and therapy vol. 2,2 (2015): 113-125. doi: https://doi.org/10.1007/s40744-015-0020-0
Madan J, Ades T, Barton P, Bojke L, Choy E, Helliwell P, Jobanputra P, Stein K, Stevens A, Tosh J, Verstappen S, Wailoo A. Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party. Rheumatol Ther. 2015 Dec;2(2):113-125. doi: 10.1007/s40744-015-0020-0. Epub 2015 Nov 25. PMID: 27747536; PMCID: PMC4883267.
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Rheumatol Ther. 2015 Dec;2(2):113-125. doi: 10.1007/s40744-015-0020-0. Epub 2015 Nov 25.

Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party.

Rheumatology and therapy

Jason Madan, Tony Ades, Pelham Barton, Laura Bojke, Ernest Choy, Philip Helliwell, Paresh Jobanputra, Ken Stein, Andrew Stevens, Jonathan Tosh, Suzanne Verstappen, Allan Wailoo

Affiliations

  1. School of Social and Community Medicine, University of Bristol, Bristol, UK. [email protected].
  2. Warwick Medical School, University of Warwick, Warwick, UK. [email protected].
  3. School of Social and Community Medicine, University of Bristol, Bristol, UK.
  4. School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
  5. Centre for Health Economics, University of York, York, UK.
  6. Cardiff Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK.
  7. Leeds and St Luke's Hospital, Bradford, UK.
  8. Queen Elizabeth Medical Centre, Birmingham, UK.
  9. Peninsular Technology Assessment Group, University of Exeter Medical School, Exeter, UK.
  10. School of Health and Related Research, University of Sheffield, Sheffield, UK.
  11. Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK.

PMID: 27747536 PMCID: PMC4883267 DOI: 10.1007/s40744-015-0020-0

Abstract

INTRODUCTION: Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies.

METHODS: Our working party consisted of clinical specialists, modelers, and policy makers. Two 1-day meetings were held for members to arrive at consensus positions on model structure, assumptions, and appropriate data sources. These views were guided by clinical aspects of rheumatoid and psoriatic arthritis and the principles of evidence-based medicine. Where opinions differed, we sought to identify a research agenda that would generate the evidence needed to reach consensus.

RESULTS: We gained consensus in four areas of model development: initial response to treatment; long-term disease progression; lifetime costs and benefits; and model structure. Consensus was also achieved on some key parameters such as choices of outcome measures, methods for extrapolation beyond trial data, and treatment switching. A research agenda to support further consensus was also identified.

CONCLUSION: Consensus guidance that fully reflects current evidence and clinical understanding was gained successfully. In addition, research needs have been identified. Such guidance can be updated as evidence develops and policy questions change and need not be prescriptive as long as deviations from consensus are clearly explained and justified.

FUNDING: Arthritis Research UK and the UK Medical Research Council Network of Hubs for Trials Methodology Research.

Keywords: Arthritis; Biologics; Economic models

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