Using whole disease modelling to evaluate all key interventions for schizophrenia
Huajie Jin, Senior Health Economist, King’s College London
Monday, 16 September 2019, 2.30pm to 3.30pm
Big Data Institute, Lower Ground Seminar Room, University of Oxford Old Road Campus, OX3 7LF
Hosted by HERC
Abstract: A patient-level WDM was developed using discrete-event simulation (DES) model. The WDM reflects disease and treatment pathways for people at high risk of psychoses or with a diagnosis of schizophrenia, and was used to evaluate options for service change at different points across the whole care pathway. The analyses were conducted from the perspective of the NHS and Personal Social Services (PSS) over a lifetime horizon. The schizophrenia WDM was used to address five decision topics identified from the national institute for health and care excellence (NICE) schizophrenia guidelines, covering cognitive behaviour therapy (CBT), family intervention, antipsychotics and crisis resolution and home treatment team (CRHT). Two alternative decision rules were used: (1) a simple threshold-based decision rule; (2) disease-level constrained maximisation assuming a fixed budget constraint.
The WDM was capable of evaluating the cost and effectiveness outcomes for all 19 interventions covered by the five decision topics and allows investment and disinvestment decisions to be made at the same time. Changes to existing system configurations altered the conclusion of the most cost-effective interventions for two topics; while use of different decision rules altered the conclusion for one topic. The WDM can capture the interactions between interventions and allow use of alternative decision rules, both of which were shown to have an impact on the cost-effectiveness conclusions.
Biography: Huajie Jin (Lily) joined King’s College London in 2013 as a senior health economist. Her research focuses on economic modelling and trial-based economic evaluation for mental health diseases and cancer. Lily gained a BSc in Medicine in the People’s Republic of China in 2008 and completed her MSc in International Health Policy (health Economics stream) at the London School of Economics and Political Science in 2009. Following the completion of her MSc, she worked on the NICE (National Institute for Health and Care Excellence) clinical guidelines for three years: first year as a systematic reviewer, second and third year as a health economist. At the moment, Lily is doing a part-time PhD with KCL. Her PhD aims to build a patient-level whole disease model (WDM) which covers the entire care pathway for schizophrenia. This WDM can be used to compare the cost-effectiveness of all key interventions (CBT, family intervention, antipsychotics, crisis resolution and home treatment team) for schizophrenia patients.