Abstract
We develop a general framework for optimal health policy design in a dynamic setting. We consider a hypothetical medical intervention for a cohort of patients where one parameter varies across cohorts with imperfectly observable linear dynamics. We seek to identify the optimal time to change the current health intervention policy and the optimal time to collect decision-relevant information. We formulate this problem as a discrete-time, infinite-horizon Markov decision process and we establish structural properties in terms of first and second-order monotonicity. We demonstrate that it is generally optimal to delay information acquisition until an effect on decisions is sufficiently likely. We apply this framework to the evaluation of hepatitis C virus (HCV) screening in the general population determining which birth cohorts to screen for HCV and when to collect information about HCV prevalence.
Highlights
There is currently no guidance for determining the optimal schedule for collecting additional information regarding a decision to invest in a health program or technology [1, 2]
The large difference between men and women is attributable to higher hepatitis C virus (HCV) prevalence and higher marginal Incremental net monetary benefit (INMB) of early diagnosis and treatment in men
Our analysis shows that when parameters vary across intervention cohorts, it may be optimal to delay information acquisition
Summary
There is currently no guidance for determining the optimal schedule for collecting additional information regarding a decision to invest in a health program or technology [1, 2]. In many cases the cost-effectiveness of a health program or technology – and, the value of additional information about one or more model parameters – may be changing over time because of trends affecting the cohort or the intervention [6]. In these cases, collecting additional information immediately may not be optimal and value-of-information calculations based on static parameter assumptions are likely to be biased. Standard approaches to finding the value of information do not usually include the option to delay the information acquisition
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