Integration of Patients' Decision-Making in Cost-Effectiveness Analysis of Diabetes Interventions: A Simulation Study Using System Dynamics Modeling

24 Pages Posted: 28 Sep 2016

See all articles by Judy Xu

Judy Xu

Southwestern University of Finance and Economics, School of Public Administration

Shiyong Liu

Southwestern University of Finance and Economics (SWUFE) - Research Institute of Economics & Management

Gordon Guoen Liu

Peking University - Guanghua School of Management

David Bishai

Johns Hopkins University - Department of Population and Family Health Sciences

Hong Xue

State University of New York (SUNY) - Department of Epidemiology and Environmental Health

Youfa Wang

Johns Hopkins University - Bloomberg School of Public Health

Date Written: September 20, 2016

Abstract

Markov-based and discrete event simulation models are widely used in health economic analysis to estimate the long term effects of treatment on clinical and economic outcomes. However, none of them simultaneously integrate patients’ economic resources and their medical decision making in the simulation.

This study applied systems dynamics modeling into cost-effectiveness analysis (CEA) of glycemic control treatment. It explored the nonlinear dynamic impacts of patients’ behavior on the cost effectiveness of different interventions to better understand the complexity of diabetes patients’ medical choices in the real world and their impacts on the clinical and economic consequences.

Our results showed that the cost-effectiveness ratio varied with patients’ out-of-pocket payment threshold for health care. It suggests that patients’ decision making of cost-related non-adherence with medication should be considered while conducting CEA for treatment of complex chronic condition like diabetes.

This study offers insight into the current dynamics of health care costs and outcomes. While providing a framework for CEA with integration of diabetes treatment adherence, it opens up ways of evaluate the complexity of health care for chronic condition in the real world.

Keywords: Patient Decision-Making; Cost-Effectiveness Analysis; Type 2 Diabetes; System Dynamics Model

JEL Classification: I1, I12, I13, I18

Suggested Citation

Xu, Judy and Liu, Shiyong and Liu, Gordon Guoen and Bishai, David and Xue, Hong and Wang, Youfa, Integration of Patients' Decision-Making in Cost-Effectiveness Analysis of Diabetes Interventions: A Simulation Study Using System Dynamics Modeling (September 20, 2016). Available at SSRN: https://ssrn.com/abstract=2841500 or http://dx.doi.org/10.2139/ssrn.2841500

Judy Xu

Southwestern University of Finance and Economics, School of Public Administration ( email )

55 Guanghuacun St,
Chengdu, Sichuan 610074
China

Shiyong Liu (Contact Author)

Southwestern University of Finance and Economics (SWUFE) - Research Institute of Economics & Management ( email )

55 Guanghuacun Street
Chengdu, Sichuan 610074
China

Gordon Guoen Liu

Peking University - Guanghua School of Management ( email )

Peking University
Beijing, Beijing 100871
China

David Bishai

Johns Hopkins University - Department of Population and Family Health Sciences ( email )

615 N. Wolfe St.
Baltimore, MD 21205
United States

Hong Xue

State University of New York (SUNY) - Department of Epidemiology and Environmental Health ( email )

Buffalo, NY
United States

Youfa Wang

Johns Hopkins University - Bloomberg School of Public Health ( email )

615 North Wolfe Street
Baltimore, MD 21205
United States

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
108
Abstract Views
797
rank
296,500
PlumX Metrics