Abstract
Several decision-analytic modeling techniques are in use for pharmacoeconomic analyses. Discretely integrated condition event (DICE) simulation is proposed as a unifying approach that has been deliberately designed to meet the modeling requirements in a straightforward transparent way, without forcing assumptions (e.g., only one transition per cycle) or unnecessary complexity. At the core of DICE are conditions that represent aspects that persist over time. They have levels that can change and many may coexist. Events reflect instantaneous occurrences that may modify some conditions or the timing of other events. The conditions are discretely integrated with events by updating their levels at those times. Profiles of determinant values allow for differences among patients in the predictors of the disease course. Any number of valuations (e.g., utility, cost, willingness-to-pay) of conditions and events can be applied concurrently in a single run. A DICE model is conveniently specified in a series of tables that follow a consistent format and the simulation can be implemented fully in MS Excel, facilitating review and validation. DICE incorporates both state-transition (Markov) models and non-resource-constrained discrete event simulation in a single formulation; it can be executed as a cohort or a microsimulation; and deterministically or stochastically.
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Acknowledgments
The assistance of Jörgen Möller in developing the example DICE available online is much appreciated.
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No funding was received for the work reported in this paper.
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The author is an employee of a consultancy, Evidera, which develops pharmacoeconomic models. The DICE method is, however, freely available to anyone who wishes to use it, without restrictions.
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Supplementary file is a plain Excel workbook that has been locked to prevent inadvertent modification. In order to open the file, please obtain LockXLS runtime from http://www.lockxls.com/download.asp. Follow the instructions for downloading and installing the runtime version (either 32 or 64 bit, depending on your installation of Windows). Then, open the MS Excel workbook named DICEd2-02L.xlsm. Note, this version only works with Windows MS Excel.
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Caro, J.J. Discretely Integrated Condition Event (DICE) Simulation for Pharmacoeconomics. PharmacoEconomics 34, 665–672 (2016). https://doi.org/10.1007/s40273-016-0394-z
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DOI: https://doi.org/10.1007/s40273-016-0394-z