To maximize the value of society's health care dollars, decision makers at all levels need tools to systematically compare costs and benefits associated with health care interventions. Evaluating the cost-effectiveness of patient-focused interventions is particularly challenging, especially in developing accurate and comprehensive cost assessments of such interventions and projecting their long-term impact on health and quality of life. The objective of the proposed project, TEAM-HF: Tools for Economic Analysis of Patient Management Interventions in Heart Failure, is to develop tools to facilitate the conduct of high-quality economic evaluations of health care interventions in heart failure, particularly those that involve patient-focused educational or behavioral modification elements. This application outlines 4 projects that will (1) aid in the application of standard costing methods;(2) facilitate the conduct of formal cost-effectiveness analyses;and (3) demonstrate the power of disease simulation modeling in identifying opportunities for greater program efficiency and high-value research. In the first project, a costing tool composed of a series of spreadsheets will be designed to systematically estimate costs associated with implementing and maintaining a patient-focused intervention. This tool could be applied to programs targeting any medical condition. The second project involves the development of a user-friendly, probabilistic, disease simulation model to evaluate short- and long-term costs and health outcomes in heart failure. This tool could be applied to patient-focused or other medical interventions provided to patients with heart failure. The model will be developed using a rich set of longitudinal data from a recently completed, large NIH-sponsored trial in heart failure (HF-ACTION). Both the costing tool and the disease simulation model will be developed using Microsoft Excel to allow for wide dissemination to potential users. The third and fourth projects will use the disease simulation model to reverse engineer patient-centered interventions that are most likely to be cost-effective and to conduct value-of-information analyses to prioritize future research efforts.
There is an increasing need to limit growth in health spending in the United States. Economic evaluation provides a tool to discriminate between higher-value and lower-value health care interventions. The TEAM-HF projects will provide clinicians and researchers with user-friendly tools to facilitate the conduct of high-quality economic evaluations of patient-focused interventions.
