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Conference Paper/Proceeding/Abstract 697 views

Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis

Shaun Harris Orcid Logo, Deborah Fitzsimmons, Roshan das Nair Orcid Logo, Lucy Bradshaw

Economic Evaluations

Swansea University Author: Shaun Harris Orcid Logo

Abstract

Abstract Summary: People with traumatic brain injuries (TBIs) commonly report memory impairments. Within the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis examined the costs and effects of a group memory rehabilitation program for people with TBI. Our cost-utility ana...

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Published in: Economic Evaluations
Published: Vancouver, Canada HTAi 2018 Annual Meeting 2018
Online Access: https://htai.org/wp-content/uploads/2018/08/AM18_Abstract-Book.pdf
URI: https://cronfa.swan.ac.uk/Record/cronfa43221
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2019-01-08T15:51:16.0493932</datestamp><bib-version>v2</bib-version><id>43221</id><entry>2018-08-06</entry><title>Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis</title><swanseaauthors><author><sid>10b1bd08dbad1f2681ff1e527af9f9a3</sid><ORCID>0000-0001-7724-6621</ORCID><firstname>Shaun</firstname><surname>Harris</surname><name>Shaun Harris</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2018-08-06</date><deptcode>PHAC</deptcode><abstract>Abstract Summary: People with traumatic brain injuries (TBIs) commonly report memory impairments. Within the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis examined the costs and effects of a group memory rehabilitation program for people with TBI. Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings were subject to considerable uncertainty. Introduction: People with traumatic brain injuries (TBIs) commonly report memory impairments which are persistent, debilitating, and reduce quality of life. As part of the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis was undertaken to examine the comparative costs and effects of a group memory rehabilitation program for people with TBI. Methods: Individual-level cost and outcome data were collected. Patients were randomized to usual care (n=157) or usual care plus memory rehabilitation (n=171). The primary outcome for the economic analysis was the EuroQol-5D quality of life score at 12- months. A UK NHS costing perspective was used. Missing data was addressed by multiple imputation. One-way sensitivity analyses examined the impact of varying different parameters, and the impact of available cases, on base case findings whilst non-parametric bootstrapping examined joint uncertainty. Results: At 12- months, the intervention was GBP 26.89 (USD 35.76) (se 249.15) cheaper than usual care; but this difference was statistically non-significant (p=0.914). At 12- months, a QALY loss of -0.007 was observed in the intervention group confidence interval (95% CI: -0.025 - 0.012) and a QALY gain seen in the usual care group 0.004 (95% CI: -0.017 &#x2013; 0.025). This difference was not statistically significant (p=0.442). The base case analysis gave an ICER of GBP 2,445 (USD 3,252) reflecting that the intervention was less effective and less costly compared to usual care. Sensitivity analyses illustrated considerable uncertainty. When joint uncertainty was examined, the probability of the intervention being cost-effective at a willingness-to-pay threshold of GBP 20,000 per QALY gain was 29 percent and 24 percent at GBP 30,000. Conclusions: Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings must be interpreted in the light of small statistically non&#x2013;significant differences and considerable uncertainty was evident. The ReMemBrIn intervention is unlikely to be considered cost-effective for people with TBI.</abstract><type>Conference Paper/Proceeding/Abstract</type><journal>Economic Evaluations</journal><publisher>HTAi 2018 Annual Meeting</publisher><placeOfPublication>Vancouver, Canada</placeOfPublication><keywords>Cost-Utility Traumatic Brain Injury</keywords><publishedDay>3</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2018</publishedYear><publishedDate>2018-06-03</publishedDate><doi/><url>https://htai.org/wp-content/uploads/2018/08/AM18_Abstract-Book.pdf</url><notes/><college>COLLEGE NANME</college><department>Public Health</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PHAC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-01-08T15:51:16.0493932</lastEdited><Created>2018-08-06T09:15:00.5232937</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>Shaun</firstname><surname>Harris</surname><orcid>0000-0001-7724-6621</orcid><order>1</order></author><author><firstname>Deborah</firstname><surname>Fitzsimmons</surname><order>2</order></author><author><firstname>Roshan</firstname><surname>das Nair</surname><orcid>https://orcid.org/0000-0001-8143-7893</orcid><order>3</order></author><author><firstname>Lucy</firstname><surname>Bradshaw</surname><order>4</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2019-01-08T15:51:16.0493932 v2 43221 2018-08-06 Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis 10b1bd08dbad1f2681ff1e527af9f9a3 0000-0001-7724-6621 Shaun Harris Shaun Harris true false 2018-08-06 PHAC Abstract Summary: People with traumatic brain injuries (TBIs) commonly report memory impairments. Within the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis examined the costs and effects of a group memory rehabilitation program for people with TBI. Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings were subject to considerable uncertainty. Introduction: People with traumatic brain injuries (TBIs) commonly report memory impairments which are persistent, debilitating, and reduce quality of life. As part of the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis was undertaken to examine the comparative costs and effects of a group memory rehabilitation program for people with TBI. Methods: Individual-level cost and outcome data were collected. Patients were randomized to usual care (n=157) or usual care plus memory rehabilitation (n=171). The primary outcome for the economic analysis was the EuroQol-5D quality of life score at 12- months. A UK NHS costing perspective was used. Missing data was addressed by multiple imputation. One-way sensitivity analyses examined the impact of varying different parameters, and the impact of available cases, on base case findings whilst non-parametric bootstrapping examined joint uncertainty. Results: At 12- months, the intervention was GBP 26.89 (USD 35.76) (se 249.15) cheaper than usual care; but this difference was statistically non-significant (p=0.914). At 12- months, a QALY loss of -0.007 was observed in the intervention group confidence interval (95% CI: -0.025 - 0.012) and a QALY gain seen in the usual care group 0.004 (95% CI: -0.017 – 0.025). This difference was not statistically significant (p=0.442). The base case analysis gave an ICER of GBP 2,445 (USD 3,252) reflecting that the intervention was less effective and less costly compared to usual care. Sensitivity analyses illustrated considerable uncertainty. When joint uncertainty was examined, the probability of the intervention being cost-effective at a willingness-to-pay threshold of GBP 20,000 per QALY gain was 29 percent and 24 percent at GBP 30,000. Conclusions: Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings must be interpreted in the light of small statistically non–significant differences and considerable uncertainty was evident. The ReMemBrIn intervention is unlikely to be considered cost-effective for people with TBI. Conference Paper/Proceeding/Abstract Economic Evaluations HTAi 2018 Annual Meeting Vancouver, Canada Cost-Utility Traumatic Brain Injury 3 6 2018 2018-06-03 https://htai.org/wp-content/uploads/2018/08/AM18_Abstract-Book.pdf COLLEGE NANME Public Health COLLEGE CODE PHAC Swansea University 2019-01-08T15:51:16.0493932 2018-08-06T09:15:00.5232937 Faculty of Medicine, Health and Life Sciences School of Health and Social Care Shaun Harris 0000-0001-7724-6621 1 Deborah Fitzsimmons 2 Roshan das Nair https://orcid.org/0000-0001-8143-7893 3 Lucy Bradshaw 4
title Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
spellingShingle Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
Shaun Harris
title_short Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
title_full Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
title_fullStr Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
title_full_unstemmed Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
title_sort Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis
author_id_str_mv 10b1bd08dbad1f2681ff1e527af9f9a3
author_id_fullname_str_mv 10b1bd08dbad1f2681ff1e527af9f9a3_***_Shaun Harris
author Shaun Harris
author2 Shaun Harris
Deborah Fitzsimmons
Roshan das Nair
Lucy Bradshaw
format Conference Paper/Proceeding/Abstract
container_title Economic Evaluations
publishDate 2018
institution Swansea University
publisher HTAi 2018 Annual Meeting
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
url https://htai.org/wp-content/uploads/2018/08/AM18_Abstract-Book.pdf
document_store_str 0
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description Abstract Summary: People with traumatic brain injuries (TBIs) commonly report memory impairments. Within the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis examined the costs and effects of a group memory rehabilitation program for people with TBI. Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings were subject to considerable uncertainty. Introduction: People with traumatic brain injuries (TBIs) commonly report memory impairments which are persistent, debilitating, and reduce quality of life. As part of the Rehabilitation of Memory in Brain Injury trial, a cost-effectiveness analysis was undertaken to examine the comparative costs and effects of a group memory rehabilitation program for people with TBI. Methods: Individual-level cost and outcome data were collected. Patients were randomized to usual care (n=157) or usual care plus memory rehabilitation (n=171). The primary outcome for the economic analysis was the EuroQol-5D quality of life score at 12- months. A UK NHS costing perspective was used. Missing data was addressed by multiple imputation. One-way sensitivity analyses examined the impact of varying different parameters, and the impact of available cases, on base case findings whilst non-parametric bootstrapping examined joint uncertainty. Results: At 12- months, the intervention was GBP 26.89 (USD 35.76) (se 249.15) cheaper than usual care; but this difference was statistically non-significant (p=0.914). At 12- months, a QALY loss of -0.007 was observed in the intervention group confidence interval (95% CI: -0.025 - 0.012) and a QALY gain seen in the usual care group 0.004 (95% CI: -0.017 – 0.025). This difference was not statistically significant (p=0.442). The base case analysis gave an ICER of GBP 2,445 (USD 3,252) reflecting that the intervention was less effective and less costly compared to usual care. Sensitivity analyses illustrated considerable uncertainty. When joint uncertainty was examined, the probability of the intervention being cost-effective at a willingness-to-pay threshold of GBP 20,000 per QALY gain was 29 percent and 24 percent at GBP 30,000. Conclusions: Our cost-utility analysis indicates that memory rehabilitation was cheaper but less effective than usual care but these findings must be interpreted in the light of small statistically non–significant differences and considerable uncertainty was evident. The ReMemBrIn intervention is unlikely to be considered cost-effective for people with TBI.
published_date 2018-06-03T03:54:29Z
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