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A SYSTEMATIC APPROACH FOR ASSESSING, IN THE ABSENCE OF FULL EVIDENCE, WHETHER MULTICOMPONENT INTERVENTIONS CAN BE MORE COST-EFFECTIVE THAN SINGLE COMPONENT INTERVENTIONS

Part of: Special Collection - Methods

Published online by Cambridge University Press:  11 September 2017

Janne C. Mewes ,
Lotte M.G. Steuten ,
Maarten J. IJzerman  and
Wim H. van Harten
Janne C. Mewes
Affiliation:
Health Technology and Services Research, Faculty of Behavioral, Management and Social Sciences, University of Twente
Lotte M.G. Steuten
Affiliation:
Hutchinson Institute for Cancer Outcomes Research & University of Washington
Maarten J. IJzerman
Affiliation:
Health Technology and Services Research, Faculty of Behavioral, Management and Social Sciences, and MIRA Institute for Biomedical Technology & Technical Medicine, University of Twente
Wim H. van Harten
Affiliation:
Health Technology and Services Research, Faculty of Behavioral, Management and Social Sciences, University of Twente Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Rijnstate General Hospitalw.v.harten@nki.nl
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Abstract

Objectives: Multicomponent interventions (MCIs), consisting of at least two interventions, are common in rehabilitation and other healthcare fields. When the effectiveness of the MCI versus that of its single interventions is comparable or unknown, evidence of their expected incremental cost-effectiveness can be helpful in deciding which intervention to recommend. As such evidence often is unavailable this study proposes an approach to estimate what is more cost-effective; the MCI or the single intervention(s).

Methods: We reviewed the literature for potential methods. Of those identified, headroom analysis was selected as the most suitable basis for developing the approach, based on the criteria of being able to estimate the cost-effectiveness of the single interventions versus that of the MCI (a) within a limited time frame, (b) in the absence of full data, and (c) taking into account carry-over and interaction effects. We illustrated the approach with an MCI for cancer survivors.

Results: The approach starts with analyzing the costs of the MCI. Given a specific willingness-to-pay-value, it is analyzed how much effectiveness the MCI would need to generate to be considered cost-effective, and if this is likely to be attained. Finally, the cost-effectiveness of the single interventions relative to the potential of the MCI for being cost-effective can be compared.

Conclusions: A systematic approach using headroom analysis was developed for estimating whether an MCI is likely to be more cost effective than one (or more) of its single interventions.

Keywords

Cost-effectivenessMulticomponentMultidimensionalMethodology
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 4: Mini-Theme: Stories of HTA Impact , 2017 , pp. 444 - 453
Copyright
Copyright © Cambridge University Press 2017 

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