DALYs in Markov Model Cost Effectiveness Analysis
Sarah Tan
Hi, I am working on a Markov Model Cost-Effectiveness Analysis and wanted to ask if anyone has any updates on how to calculate DALYs in TreeAge instead of QALYs?
Is it as simple as setting all utility values for "death" states to 1, "well" or "disease free" states to 0, and using disability weights (DWs) instead of utility values for disease states?
Comments
DALYs are trickier than QALYs in a TreeAge Pro Markov model.
QALYs are easily accumulated at each state based on the current utility.
DALYs are the opposite, (1 - utility) at each state.
In addition, DALYs need to account for death, so DALYs would need to be accumulated for each cycle spent in the Dead state. Enter 1 for the dead state Incr reward and 0.5 for the Final reward assuming you are doing half-cycle correction.
Note that this example model is included with TreeAge Pro 2021 and later.
Files View > Example Models > Healthcare > Markov Cancer Decision - DALY.trex.
Hi Andrew,
Just following up on this model. I wonder if the model can give the cost per DALY averted, instead of cost per QALY gained.
I think the model only shows the number of DALY losses that are accumulated over the cycle lengh, however, the objective is to estimate the cost per DALY averted and use all functions including sensitivity analysis.
I would be happy to learn about the functions in Treeage as I am also reporting the findings in terms of cost per DALY averted.
Thank you.
When your effectiveness measure is negative, you want a decrease to be considered better. You change that in Tree Preferences.
Tree Prefs > Calculation > Cost-Effectiveness > Cost-Eff Params > Choose invert incremental only
Andrew
Thank you Andrew, this has solved my question.
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