This is the first book to make all the central concepts of discrete event simulation relevant for health technology assessment. Accessible to beginners, the book requires no prerequisites and describes the concepts with as little jargon as possible. It presents essential concepts, a fully worked out implementation example, approaches to analyze the simulations, the development of the required equations, model verification techniques, and validation. The book also covers various special topics and includes a real case study involving screening strategies for breast cancer surveillance.
It is becoming increasingly important to examine the relationship between the outcomes of a clinical trial and the costs of the medical therapy under study. The results of such analysis can affect reimbursement decisions for new medical technologies, drugs, devices or diagnostics. It can aid companies seeking to make claims about the cost-effectiveness of their product, as well as allowing early consideration of the economic value of therapies which may be important to improving initial adoption decisions. It is also vital for addressing the requirements of regulatory bodies. Economic Evaluation in Clinical Trials provides practical advice on how to conduct cost-effectiveness analyses in controlled trials of medical therapies. This new edition has been extensively rewritten and revised; topics discussed range from design issues such as the types of services that should be measured and price weights, to assessment of quality-adjusted life years. Illustrative materials, case histories and worked examples are included to encourage the reader to apply the methods discussed. These exercises are supported with datasets, programmes and solutions made available online.
This book provides an introduction to decision analytic cost-effectiveness modelling, giving the theoretical and practical knowledge required to design and implement analyses that meet the methodological standards of health technology assessment organisations. The book guides you through building a decision tree and Markov model and, importantly, shows how the results of cost-effectiveness analyses are interpreted. Given the complex nature of cost-effectiveness modelling and the often unfamiliar language that runs alongside it, we wanted to make this book as accessible as possible whilst still providing a comprehensive, in-depth, practical guide that reflects the state of the art – that includes the most recent developments in cost-effectiveness modelling. Although the nature of cost effectiveness modelling means that some parts are inevitably quite technical, across the 13 chapters we have broken down explanations of theory and methods into bite-sized pieces that you can work through at your own pace; we have provided explanations of terms and methods as we use them. Importantly, the exercises and online workbooks allow you to test your skills and understanding as you go along.
"This is an excellent and well-written text on discrete event simulation with a focus on applications in Operations Research. There is substantial attention to programming, output analysis, pseudo-random number generation and modelling and these sections are quite thorough. Methods are provided for generating pseudo-random numbers (including combining such streams) and for generating random numbers from most standard statistical distributions." --ISI Short Book Reviews, 22:2, August 2002
The pharmaceutical industry is almost boundless in its ability to supply new drug therapies, but how does one decide which are the best medicines to use within restricted budgets? With particular emphasis on modeling, methodologies, data sources, and application to real-world dilemmas, Pharmacoeconomics: From Theory to Practice provides an introduc
A timely work describing how localized hospital-based health technology assessment (HB-HTA) complements general, ‘arms-length’ HTA agency efforts, and what has been the collective global impact of HB-HTA across the globe. While HB-HTA has gained significant momentum over the past few years, expertise in the field, and information on the operation and organization of HB-HTA, has been scattered. This book serves to bring this information together to inform those who are currently working in the field of HTA at the hospital, regional, national or global level. In addition, this book is intended for decision-makers and policy-makers with a stake in determining the uptake and decommissioning of new and established technologies in the hospital setting. HTA has traditionally been performed at the National/Regional level by HTA Agencies, typically linked to governments. Yet hospitals are the main entry door for most health technologies (HTs). Hospital decision-makers must undertake multiple high stakes investment and disinvestment decisions annually for innovative HTs, usually without adequate information. Despite the existence of arms-length HTA Agencies, inadequate information is available to hospital decision-makers either because relevant HTA reports are not yet released at the time of entry of new technologies to the field, or because even when the report exists, the information contained is insufficient to clarify the contextualized informational needs of hospital decision makers. Therefore, there has recently been a rising trend toward hospital-based HTA units and programs. These units/programs complement the work of National/Regional HTA Agencies by providing the key and relevant evidence needed by hospital decision makers in their specific hospital context, and within required decision-making timelines. The emergence of HB-HTA is creating a comprehensive HTA ecosystem across health care levels, which creates better bridges for knowledge translation through relevance and timeliness.
Over the last decades Discrete Event Simulation has conquered many different application areas. This trend is, on the one hand, driven by an ever wider use of this technology in different fields of science and on the other hand by an incredibly creative use of available software programs through dedicated experts. This book contains articles from scientists and experts from 10 countries. They illuminate the width of application of this technology and the quality of problems solved using Discrete Event Simulation. Practical applications of simulation dominate in the present book. The book is aimed to researchers and students who deal in their work with Discrete Event Simulation and which want to inform them about current applications. By focusing on discrete event simulation, this book can also serve as an inspiration source for practitioners for solving specific problems during their work. Decision makers who deal with the question of the introduction of discrete event simulation for planning support and optimization this book provides a contribution to the orientation, what specific problems could be solved with the help of Discrete Event Simulation within the organization.
This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the “macro system.” A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.
Cancer is a major healthcare burden across the world and impacts not only the people diagnosed with various cancers but also their families, carers, and healthcare systems. With advances in the diagnosis and treatment, more people are diagnosed early and receive treatments for a disease where few treatments options were previously available. As a result, the survival of patients with cancer has steadily improved and, in most cases, patients who are not cured may receive multiple lines of treatment, often with financial consequences for the patients, insurers and healthcare systems. Although many books exist that address economic evaluation, Economic Evaluation of Cancer Drugs using Clinical Trial and Real World Data is the first unified text that specifically addresses the economic evaluation of cancer drugs. The authors discuss how to perform cost-effectiveness analyses while emphasising the strategic importance of designing cost-effectiveness into cancer trials and building robust economic evaluation models that have a higher chance of reimbursement if truly cost-effective. They cover the use of real-world data using cancer registries and discuss how such data can support or complement clinical trials with limited follow up. Lessons learned from failed reimbursement attempts, factors predictive of successful reimbursement and the different payer requirements across major countries including US, Australia, Canada, UK, Germany, France and Italy are also discussed. The book includes many detailed practical examples, case studies and thought-provoking exercises for use in classroom and seminar discussions. Iftekhar Khan is a medical statistician and health economist and a lead statistician at Oxford Unviersity’s Center for Statistics in Medicine. Professor Khan is also a Senior Research Fellow in Health Economics at University of Warwick and is a Senior Statistical Assessor within the Licensing Division of the UK Medicine and Health Regulation Agency. Ralph Crott is a former professor in Pharmacoeconomics at the University of Montreal in Quebec, Canada and former head of the EORTC Health Economics Unit and former senior health economist at the Belgian HTA organization. Zahid Bashir has over twelve years experience working in the pharmaceutical industry in medical affairs and oncology drug development where he is involved in the design and execution of oncology clinical trials and development of reimbursement dossiers for HTA submission.
This highly successful textbook is now in its fourth edition, and has been extensively updated in order to keep pace with the considerable advances in theory and practice in recent years.
