PRM16 Covariance Structures for Modeling Longitudinal Data

C. Purdy
2011 Value in Health  
cluded from the review. The studies included were categorised based on criteria such as type of study, statistical methods for the learning effect, mathematical framework for the economic analysis, year of publication, country and intervention. RESULTS: The database search produced 930 articles. Only 2% of the studies obtained were included given the above criteria. Of the excluded studies, 70% were excluded as they were not economic evaluations and 23% were excluded as they did not formally
more » ... sent the learning effect. The remaining 7% were excluded based on other reasons: duplicates, non-English, non-human. The majority of the studies are published after 2000. Of the included studies, the majority presented a learning effect related to health care costs. Two percent of the included studies referred to utilities. Only one study synthesised cost and utilities. CONCLUSIONS: Although the learning effect can have a notable impact on the effectiveness of health care interventions, the economic evaluation literature on the subject is very limited. OBJECTIVES: The Mutuelle Générale des Fonctionnaires et Agents de l'État de Côte d'Ivoire (MUGEFCI) is a health mutual providing coverage services for its enrolees (medical consultations, lab tests, medication expenses). This organization aims at improving its current drug reimbursement process because of budgetary constraints. This study, therefore, aims at evaluating the feasibility of developing a new formulary for the MUGEFCI in Côte d'Ivoire, by implementing a formularylisting framework specifically designed for under researched settings. METHODS: The application of this framework, based on Multi-criteria Decision Analysis (MCDA), consisted in four steps. First of all, we identified and weighted relevant formulary listing criteria with their levels of variation. Then, we determined a set of priority diagnostic/treatments to be assessed. Furthermore, scores were assigned to these treatments according to their performance on the formulary listing criteria levels. Last, we constructed a composite league table to rank the set of treatments by priority order of reimbursement. A budget impact analysis was also conducted to appraise the economic implications of the new composite drugs league table. RESULTS: Policymakers in Côte d'Ivoire consider targeting cost-effectiveness and severity of diseases as the most significant criteria for priority reimbursement of drugs. This translates into a general preference for antimalarial, treatments for asthma and antibiotics for urinary infection. Moreover, the results of the BIA suggest that the new priority list of reimbursable drugs will be affordable when the real economic impact of drugs per patient is under 66 US dollars. Over this threshold, the MUGEFCI will have to select the reimbursable drugs according to their rank in the priority list along with their respective budget impact per patient (cost per patient). CONCLUSIONS: It is feasible to use MCDA to establish a formulary for low-income countries. The application of this method is a step forward to transparency in policymaking. 1 Agenas, Agenzia nazionale per i servizi sanitari regionali,
doi:10.1016/j.jval.2011.08.1047 fatcat:yy6zlzn3fvfkzbvfwmeeidj37y