title: Principles of health economic evaluations of lipid-lowering strategies.
abstract: OBJECTIVE
  Policy decision-making in cardiovascular disease is increasingly informed by the results generated from decision-analytic models (DAMs). The methodological approaches and assumptions used in these DAMs impact on the results generated and can influence a policy decision based on a cost per quality-adjusted life year (QALY) threshold. Decision makers need to be provided with a clear understanding of the key sources of evidence and how they are used in the DAM to make an informed judgement on the quality and appropriateness of the results generated.
  
  
  RESULTS
  Our review identified 12 studies exploring the cost-effectiveness of pharmaceutical lipid-lowering interventions published since January 2010. All studies used Markov models with annual cycles to represent the long-term clinical pathway. Important differences in the model structures and evidence base used within the DAMs were identified. Whereas the reporting standards were reasonably good, there were many instances when reporting of methods could be improved, particularly relating to baseline risk levels, long-term benefit of treatment and health state utility values.
  
  
  CONCLUSIONS
  There is a scope for improvement in the reporting of evidence and modelling approaches used within DAMs to provide decision makers with a clearer understanding of the quality and validity of the results generated. This would be assisted by fuller publication of models, perhaps through detailed web appendices.
authors.affiliation: The University of Sheffield, Sheffield, UK. r.m.ara@sheffield.ac.uk
authors.forename: Roberta
authors.initials: R
authors.lastname: Ara
authors.forename: Hasan
authors.initials: H
authors.lastname: Basarir
authors.forename: Sue Elizabeth
authors.initials: SE
authors.lastname: Ward
mesh_terms: D000924:Anticholesteremic Agents / Q000191:economics* / Q000494:pharmacology; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics*; D015438:Health Behavior; D006801:Humans; D013997:Time Factors
chemical_list: D000924:Anticholesteremic Agents