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Table 2 Parameter inputs of the model

From: Using a dynamic adherence Markov model to assess the efficiency of Respiratory Medication Therapy Adherence Clinic (RMTAC) on asthma patients in Malaysia

Parameter

Value

Range

Distribution

Low

High

Monthly transition probabilities between states A–D under RMTAC + UC

 A → B

0.122

0.03365

0.35673

Dirichlet

 A → C

0.152

0.04763

0.39112

Dirichlet

 A → D

0.030

0.00304

0.23896

Dirichlet

 B → A

0.382

0.18072

0.63454

Dirichlet

 B → C

0.032

0.00306

0.26248

Dirichlet

 B → D

0.058

0.00895

0.29784

Dirichlet

 C → A

0.184

0.08224

0.36201

Dirichlet

 C → B

0.008

0.00042

0.13430

Dirichlet

 C → D

0.043

0.00867

0.18760

Dirichlet

 D → A

0.088

0.01812

0.33530

Dirichlet

 D → B

0.051

0.00708

0.28827

Dirichlet

 D → C

0.088

0.01812

0.33530

Dirichlet

Effectiveness factor

 Asthma control

OR 3.059

1.632

5.733

Log normal

 Medication adherence

OR 1.89

1.08

3.30

Log normal

Monthly probabilities of low adherence level patient to have an exacerbation

 B → E

0.09273

0.07489

0.11021

Beta

 B → F

0.00412

0.00330

0.00495

Beta

 D → E

0.23237

0.19068

0.27191

Beta

 D → F

0.05390

0.04335

0.06432

Beta

Risks of high adherence level patient to have an exacerbation

 A → E

HR 0.72

0.34

1.51

Log normal

 A → F

HR 0.72

0.34

1.51

Log normal

 C → E

HR 0.59

0.37

0.95

Log normal

 C → F

HR 0.59

0.37

0.95

Log normal

Monthly probabilities of having good/poor asthma control after an exacerbation

 E → A

0.02528

0.01962

0.03132

Beta

 E → C

0.10484

0.07127

0.16332

Beta

 F → A

0.02394

0.01862

0.02961

Beta

 F → C

0.10738

0.07261

0.16990

Beta

Monthly probabilities of having an exacerbation after a recent exacerbation

 E → F

0.047

0.0376

0.0564

Beta

 F → E

0.047

0.0376

0.0564

Beta

Monthly probability of mortality after an exacerbation that does not involve hospitalization

 E → G

0.000059

0.000048

0.000071

Beta

Utilities input for base case analysis

 A

0.5583

0.4435

0.6731

Beta

 B

0.5583

0.4435

0.6731

Beta

 C

0.5316

0.3788

0.6844

Beta

 D

0.5316

0.3788

0.6844

Beta

 E

0.5311

0.4254

0.6368

Beta

 F

0.3842

0.2882

0.4802

Beta

Utilities input for PSA

 A

0.5598

0.4588

0.6608

Beta

 B

0.5598

0.4588

0.6608

Beta

 C

0.5316

0.3788

0.6844

Beta

 D

0.5316

0.3788

0.6844

Beta

 E

0.4514

0.3589

0.5439

Beta

 F

0.2919

0.2091

0.3747

Beta

Monthly direct cost ($)*

 A (maintenance)

38.78

33.77

43.78

Gamma

 B (maintenance)

39.70

34.70

44.71

Gamma

 C (maintenance)

42.48

37.46

47.50

Gamma

 D (maintenance)

38.67

35.62

45.64

Gamma

 E (ED management)

13.50

12.53

14.46

Log normal

 F (hospitalization)

552.13

468.03

636.23

Gamma

 RMTAC recruitment (cycle 0)

12.38

9.30

15.48

Gamma

 RMTAC 3 monthly follow-up (cycle 1–15)

2.23

1.91

2.54

Gamma

 RMTAC biannual follow-up (cycle 16 and above)

1.11

0.96

1.27

Gamma

  1. A, good control–high adherence; B, good control–low adherence; C, poor control–high adherence; D, poor control–low adherence; E, exacerbation without hospitalization (Emergency Department visit); F, severe exacerbation with hospitalization; G, death due to asthma; PSA, probabilistic sensitivity analysis; RMTAC, Respiratory Medication Therapy Adherence Clinic; UC, usual care
  2. * Monthly direct cost is expressed in 2014 US dollars ($)
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Cost Effectiveness and Resource Allocation

ISSN: 1478-7547

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