TY - JOUR
T1 - The transferability and validity of a population-level simulation model for the economic evaluation of interventions in diabetes
T2 - the MICADO model
AU - Emamipour, Sajad
AU - Pagano, Eva
AU - di Cuonzo, Daniela
AU - Konings, Stefan R. A.
AU - van der Heijden, Amber A.
AU - Elders, Petra
AU - Beulens, Joline W. J.
AU - Leal, Jose
AU - Feenstra, Talitha L.
N1 - Funding Information: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 754425 and the Innovative Medicines Initiative 2 Joint Undertaking under Grant agreement No 115881 (RHAPSODY). Publisher Copyright: © 2022, The Author(s).
PY - 2022/7
Y1 - 2022/7
N2 - Aims: Valid health economic models are essential to inform the adoption and reimbursement of therapies for diabetes mellitus. Often existing health economic models are applied in other countries and settings than those where they were developed. This practice requires assessing the transferability of a model developed from one setting to another. We evaluate the transferability of the MICADO model, developed for the Dutch 2007 setting, in two different settings using a range of adjustment steps. MICADO predicts micro- and macrovascular events at the population level. Methods: MICADO simulation results were compared to observed events in an Italian 2000–2015 cohort (Casale Monferrato Survey [CMS]) and in a Dutch 2008–2019 (Hoorn Diabetes Care Center [DCS]) cohort after adjusting the demographic characteristics. Additional adjustments were performed to: (1) risk factors prevalence at baseline, (2) prevalence of complications, and (3) all-cause mortality risks by age and sex. Model validity was assessed by mean average percentage error (MAPE) of cumulative incidences over 10 years of follow-up, where lower values mean better accuracy. Results: For mortality, MAPE was lower for CMS compared to DCS (0.38 vs. 0.70 following demographic adjustment) and adjustment step 3 improved it to 0.20 in CMS, whereas step 2 showed best results in DCS (0.65). MAPE for heart failure and stroke in DCS were 0.11 and 0.22, respectively, while for CMS was 0.42 and 0.41. Conclusions: The transferability of the MICADO model varied by event and per cohort. Additional adjustments improved prediction of events for MICADO. To ensure a valid model in a new setting it is imperative to assess the impact of adjustments in terms of model accuracy, even when this involves the same country, but a new time period.
AB - Aims: Valid health economic models are essential to inform the adoption and reimbursement of therapies for diabetes mellitus. Often existing health economic models are applied in other countries and settings than those where they were developed. This practice requires assessing the transferability of a model developed from one setting to another. We evaluate the transferability of the MICADO model, developed for the Dutch 2007 setting, in two different settings using a range of adjustment steps. MICADO predicts micro- and macrovascular events at the population level. Methods: MICADO simulation results were compared to observed events in an Italian 2000–2015 cohort (Casale Monferrato Survey [CMS]) and in a Dutch 2008–2019 (Hoorn Diabetes Care Center [DCS]) cohort after adjusting the demographic characteristics. Additional adjustments were performed to: (1) risk factors prevalence at baseline, (2) prevalence of complications, and (3) all-cause mortality risks by age and sex. Model validity was assessed by mean average percentage error (MAPE) of cumulative incidences over 10 years of follow-up, where lower values mean better accuracy. Results: For mortality, MAPE was lower for CMS compared to DCS (0.38 vs. 0.70 following demographic adjustment) and adjustment step 3 improved it to 0.20 in CMS, whereas step 2 showed best results in DCS (0.65). MAPE for heart failure and stroke in DCS were 0.11 and 0.22, respectively, while for CMS was 0.42 and 0.41. Conclusions: The transferability of the MICADO model varied by event and per cohort. Additional adjustments improved prediction of events for MICADO. To ensure a valid model in a new setting it is imperative to assess the impact of adjustments in terms of model accuracy, even when this involves the same country, but a new time period.
KW - Cardiovascular disease
KW - Diabetes complications
KW - Health economics
KW - Transferability
UR - http://www.scopus.com/inward/record.url?scp=85128502749&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00592-022-01891-2
DO - https://doi.org/10.1007/s00592-022-01891-2
M3 - Article
C2 - 35445871
SN - 0940-5429
VL - 59
SP - 949
EP - 957
JO - Acta Diabetologica
JF - Acta Diabetologica
IS - 7
ER -