Modeling the cost-effectiveness and budgetary impact for subpopulations.

There is currently a trend to increasing demand for health-economic and budgetary-impact data in the decision-making process in Europe. A parallel development is the tendency to restrict the prescription of new drugs to subpopulations that may depend on the results of the above health-economic analysis and financial analysis. We present modeling techniques for determining the optimal subpopulation considering the cost-effectiveness and budgetary impact of a new drug. The methodology consists of incorporating confounding variables into the Markov health states by means of health state specific regression equations for costs and utilities. The strategy is applied to a hypothetical Markov model for new product in Parkinson's disease. The results of the presented analyses suggest that within the registered range of indications a further restriction in the application for a new drug can be made from the point of view of cost-effectiveness and budgetary impact. These results can also be considered in the decision-making process.