Economic evaluation of chronic conditions: Framework for a quasi-Markov process

This paper presents a general model for economic evaluation of treatments of chronic conditions. The model is applicable in the situation where multiple possible treatments are available none of which is completely satisfactory by virtue of either lack of effect or adverse effects occurring for some patients. Treatments may include any process designed to enable patients to manage their condition. Since none are completely satisfactory, the model cannot determine the ‘best’ treatment, merely help identify an order in which treatments should be tried. This economic model must be used in conjunction with clinical or other relevant information. The model should be used to make comparisons between treatment options within one discrete category. The information provided can thus assist allocative microeconomic decisions, where funds must be allocated between specific competing alternatives. These decisions may apply to either purchasers or providers of health care services.