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IVI at ISPOR 20192019-05-06T16:26:20-06:00

IVI is Headed to the Big Easy

IVI is planning for a high-impact visit to New Orleans in May to participate in the ISPOR 2019 annual conference from May 18th through May 22nd. With a podium presentation, two issue panels, and a workshop, IVI will have a power-packed agenda. Read more about each of our appearances below.

We look forward to seeing you there!

Join the IVI Discussion

IVI will be posting updates throughout the conference, so be sure to follow us on Twitter! Join our Twitter conversations using any of the hashtags below. Also, keep an eye out for our LIVE tweets using #IVItalks. We are looking forward to a lively discussion!

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Panel Presentations

Jennifer Bright, MPH
Executive Director

The Controversial QALY – Is There a Middle Ground in the Debate?
Monday, May 20, 2019 (11:00am – 12:00pm CT)
Breakout Session 1, IP1

Overview: The QALY has long been a source of controversy among academics, patients, and industry and policy stakeholders. With valid arguments on both sides of the debate, is there a middle ground, and how can it be reached under intensifying budget pressure? Can concerns about the QALY be addressed to the satisfaction of all? Jennifer Bright will moderate and provide context on the ongoing debate and recent developments in the US. Lou Garrison will provide background on the use of QALYs in CEA and value assessment and outline the arguments in favor of the QALY. Eleanor Perfetto will describe the criticisms of the QALY and represent the perspective of concerned patients. Anna Kaltenboeck will provide perspective on the practical challenges confronting value assessors and opportunities to learn from other countries. Panelists will provide brief presentations, with 30 minutes reserved for panel discussion and audience questions.

Moderator

  • Jennifer Bright, MPA (Innovation and Value Initiative)

Panelists

  • Lou Garrison, PhD (University of Washington)
  • Anna Kaltenboeck, MA (Memorial Sloan Kettering Cancer Center)
  • Eleanor Perfetto, PhD, MS (National Health Council)

Jeroen Jansen, PhD
Lead Scientific Advisor
Open-Source Value Platform

Darius Lakdawalla, PhD
Vice Chair
Strategic Advisory Panel

Are Novel Concepts of Value Ready for Prime Time?
Monday, May 20, 2019 (3:45pm – 4:45pm CT)
Breakout Session 2, IP5

Overview: Should novel measures of value be incorporated in value assessment – and if so, is the science advanced enough to do so? And what are the practical implications? Jeroen Jansen will moderate and provide an overview of the state of the science on several novel concepts of value, such as insurance value and the value of hope. As a coauthor of the ISPOR Special Task Force Report, Darius Lakdawalla will outline the arguments in support of incorporating novel measures of value into value assessment. Michael Drummond will describe the concerns and challenges with incorporating these measures from the perspective of value assessment organizations and insurers. Sachin Kamal-Bahl will provide the manufacturer’s perspective and describe practical implications of measuring and incorporating novel value measures. Panelists will provide brief presentations, with 30 minutes reserved for panel discussion and audience questions.

Moderator

  • Jeroen Jansen, PhD (Innovation and Value Initiative)

Panelists

  • Michael Drummond, MCom, DPhil (University of York)
  • Sachin Kamal-Bahl, PhD (SKB Consulting Inc.)
  • Darius Lakdawalla, PhD (University of Southern California)

Podium Presentation

Devin Incerti, PhD
Lead Economist
Open-Source Value Platform

Jeroen Jansen, PhD
Lead Scientific Advisor
Open-Source Value Platform

A Comparison of Three and Four State Economic Models for Cost-Effectiveness Analysis in Oncology
Monday, May 20, 2019 (3:45pm – 4:00pm CT)
Breakout Session 2, P3, MS1

Objectives: Cost-effectiveness analyses in oncology are typically based on model structures with three health states. The aim of this study was to compare a 4-state model that explicitly simulates sequential treatment strategies with the standard 3-state approach.

Methods: We used the open-source IVI-NSCLC model to evaluate the cost-effectiveness of a treatment strategy starting with gefintinib (comparator) to a strategy starting with erlotinib for treating epidermal growth factor receptive positive patients with metastatic non small cell lung cancer. In the 3-state model, the health states are stable disease with first line (1L) treatment (S1), progressed disease with 1L treatment (P1), and death. The 4-state model adds a fourth health state, progressed disease on 2L treatment (P2). In the 3-state model, state transitions are based on 1L treatment whereas in the 4-state model transitions from S1 are based on 1L treatment while transitions from P1 and P2 are based on 2L treatment. Costs in the 3-state model in P1 are based on 2L treatment; in the 4-state model costs in P1 are based on 2L treatment and costs in P2 are based on post 2L treatment. Transition rates were estimated using a novel multi-state network meta-analysis.

Results: Incremental quality adjusted life-years and incremental costs were both higher in the 4-state model. Higher costs were driven by treatment costs after progression, which was a function of treatment duration with osimertinib before stating chemotherapy. The incremental cost effectiveness ratio increased from $75,000 in the 3-state model to $130,000 in the 4-state model.

Conclusions: Cost-effectiveness estimates with 4-state models can differ from 3-state models since 3-state models do not explicitly incorporate efficacy from 2L treatments or the duration of multiple post progression treatments. 4-state models should be considered as an alternative model structure, particularly when post progression treatments differ across the 1L evidence base used for evidence synthesis.

Authors

  • Devin Incerti, PhD (Innovation and Value Initiative) — Presenting
  • Jeroen Jansen, PhD (Innovation and Value Initiative)

Workshop

Devin Incerti, PhD
Lead Economist
Open-Source Value Platform

Jeroen Jansen, PhD
Lead Scientific Advisor
Open-Source Value Platform

Excel with Your Economic Models Using R
Tuesday, May 21, 2019 (5:00pm – 6:00pm CT)
Breakout Session 7, W15

Description: The workshop will begin with an overview of commonly used programming languages such as R, Python, and Julia and a summary of packages relevant to HTA. Development of a model using best practices in software engineering will be compared to development of a model using spreadsheet software. The discussion will then turn toward developing completely integrated economic models that combine parameter estimation, simulation, and decision analysis in the same software environment. Appropriate statistical techniques for different types of models (e.g., decision trees, partitioned survival models, state-transition models, compartmental models) and available data (e.g., single clinical trial, evidence synthesis) will be reviewed. The workshop will conclude with an example cost-effectiveness analysis using a state-transition model. A novel multi-state network meta-analysis approach utilizing flexible parametric survival models (e.g., fractional polynomials) will be used for parameterization. Computationally efficient methods will be used to simulate model outcomes and represent decision uncertainty from a probabilistic sensitivity analysis. We hope our presentations and live demonstrations will encourage a lively discussion with audience members, who will be encouraged to ask questions and share their experiences.

Discussion Leaders

  • Devin Incerti, PhD (Precision Health Economics)
  • Jeroen Jansen, PhD (Innovation and Value Initiative)
  • Joseph Levy, PhD (Johns Hopkins University)