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Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis / Shaun Harris; Deborah Fitzsimmons; Roshan das Nair; Lucy Bradshaw

Economic Evaluations

Swansea University Author: Harris, Shaun

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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spelling 2019-01-08T15:51:16Z v2 43221 2018-08-06 Rehabilitation Of Memory In Brain Injury: A Cost Utility Analysis Shaun Harris Shaun Harris true 0000-0001-7724-6621 false 10b1bd08dbad1f2681ff1e527af9f9a3 d771121cd894dbb900e1e629a60ace65 ODz8c1LaEIlqrOvHRlXlFX2HZhUyFASdV1DFdgIIhKs= 2018-08-06 HHE 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 contribution 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 of Human and Health Sciences Swansea Centre for Health Economics CHHS HHE Health Technology Assessment/Health Economics None 2019-01-08T15:51:16Z 2018-08-06T09:15:00Z College of Human and Health Sciences Swansea Centre for Health Economics Shaun Harris 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
Harris, Shaun
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_***_Harris, Shaun
author Harris, Shaun
author2 Shaun Harris
Deborah Fitzsimmons
Roshan das Nair
Lucy Bradshaw
format Conference contribution
container_title Economic Evaluations
publishDate 2018
institution Swansea University
publisher HTAi 2018 Annual Meeting
college_str College of Human and Health Sciences
hierarchytype
hierarchy_top_id collegeofhumanandhealthsciences
hierarchy_top_title College of Human and Health Sciences
hierarchy_parent_id collegeofhumanandhealthsciences
hierarchy_parent_title College of Human and Health Sciences
department_str Swansea Centre for Health Economics{{{_:::_}}}College of Human and Health Sciences{{{_:::_}}}Swansea Centre for Health Economics
url https://htai.org/wp-content/uploads/2018/08/AM18_Abstract-Book.pdf
document_store_str 0
active_str 1
researchgroup_str Health Technology Assessment/Health Economics
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 2018-06-03T22:07:44Z
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