Communicating the Parameter Uncertainty in the IQWiG Efficiency Frontier to Decision-Makers

Authors

  • Björn Stollenwerk,

    1. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
    Search for more papers by this author
  • Stefan K. Lhachimi,

    Corresponding author
    1. IQWiG, Institute for Quality and Efficiency in Health Care, Department of Health Economics, Cologne, Germany
    2. Cooperative Research Group for Evidence Based Public Health, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
    3. Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
    • Correspondence to: IQWiG, Institute for Quality and Efficiency in Health Care, Department of Health Economics, Cologne, Germany. E-mail: stefan.Lhachimi@iqwig.de

    Search for more papers by this author
  • Andrew Briggs,

    1. Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
    Search for more papers by this author
  • Elisabeth Fenwick,

    1. Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
    Search for more papers by this author
  • Jaime J. Caro,

    1. McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Division of General Internal Medicine, Montreal, Quebec, Canada
    2. United BioSource Corporation, Lexington, MA, USA
    Search for more papers by this author
  • Uwe Siebert,

    1. Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, EWZ I, Tyrol, Austria
    2. Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
    3. Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA
    4. Division of Public Health Decision Modelling, Health Technology Assessment and Health Economics, ONCOTYROL Center for Personalized Cancer Medicine, Innsbruck, Austria
    Search for more papers by this author
  • Marion Danner,

    1. Institute for Health Economics and Clinical Epidemiology, University of Colgone, Cologne, Germany
    Search for more papers by this author
  • Andreas Gerber-Grote

    1. IQWiG, Institute for Quality and Efficiency in Health Care, Department of Health Economics, Cologne, Germany
    Search for more papers by this author

Abstract

The Institute for Quality and Efficiency in Health Care (IQWiG) developed—in a consultation process with an international expert panel—the efficiency frontier (EF) approach to satisfy a range of legal requirements for economic evaluation in Germany's statutory health insurance system. The EF approach is distinctly different from other health economic approaches. Here, we evaluate established tools for assessing and communicating parameter uncertainty in terms of their applicability to the EF approach. Among these are tools that perform the following: (i) graphically display overall uncertainty within the IQWiG EF (scatter plots, confidence bands, and contour plots) and (ii) communicate the uncertainty around the reimbursable price. We found that, within the EF approach, most established plots were not always easy to interpret. Hence, we propose the use of price reimbursement acceptability curves—a modification of the well-known cost-effectiveness acceptability curves. Furthermore, it emerges that the net monetary benefit allows an intuitive interpretation of parameter uncertainty within the EF approach. This research closes a gap for handling uncertainty in the economic evaluation approach of the IQWiG methods when using the EF. However, the precise consequences of uncertainty when determining prices are yet to be defined. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

Ancillary