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We attempted to account for this by conducting several sensitivity analyses to test our assumptions of effectiveness and clinical use.
Instead, the aim was to generate an early estimate of value from an Statutory Health Insurance (SHI) perspective to identify attractive target patient groups, inform tentative value-based prices for differing assumptions of effectiveness, and derive implications for including such value considerations into product design.
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Detection of real intervention effects requires adequate control of any bias that may distort the effect so as to ensure that there is no false assumption of effectiveness and lack of possible harm.
Sowden and Raine [ 4] concur with our findings by arguing that the experimental evaluation of exercise referral in England is now unlikely because of the widespread assumption of effectiveness, the comprehensive coverage of the schemes, the indirect adverse consequences of dismantling the schemes, and the lack of appropriate process and outcome data.
For both sets of evidence, assumptions on effectiveness and cost-effectiveness based on results of modeling must be backed by evidence of scientific validity and clinical utility from systematic empirical research, such as pilot studies or clinical trials.
The model was most sensitive to assumptions of the effectiveness of ART in reducing HIV transmission probabilities.
These projections are predicated on assumptions of the effectiveness of IFN-free DAAs (based on phase 2 studies as evidence from large-scale evaluations are not yet available).
By making the assumptions of constant effectiveness and by neglecting the number of new infection occurring after treatment initiation, an analytical approximation for the multiscale model can be obtained: Eq 10where, and This analytical solution makes the interpretation of parameters easier.
To understand the impact of waning assumptions of cost-effectiveness results, three sensitivity analyses were generated: PCV13 and PPSV23 were assumed to have equivalent waning rates of 10 or 15 years; PCV13 was assumed to wane over a period of 20 years, rather than 15 years as in the base case.
The model results were insensitive to changes in the assumption of vaccine effectiveness against disease when vaccine effectiveness against carriage was high (90%), because in this situation, carriage acquisitions were rare and so few people were at risk of disease downstream.
The hesitation to use the vaccine can be explained by various factors, including the rigorous assumption of equal effectiveness of the vaccine for BPD and NBPD.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com