Discrete-event simulation based resource modelling in Health Technology Assessment

Health technology assessment (HTA) is used to assist decisions of allocating scarce resources and to gain the best value for money when funding health technologies. Economic evaluation and budget impact analysis are the two economic analyses currently feeding into HTA, typically within a deliberative framework. Whilst these analyses address efficiency and affordability, the issues of implementation and feasibility are typically ignored or captured in a qualitative manner. There is a need for a formal quantitative assessment to capture these issues in HTA, thereby achieving a more detailed analysis. This research is about resource modelling (RM), which is a quantitative assessment in understanding the resource requirements within the service pathway for each intervention (e.g. number of cardiologists required for administering angioplasty treatment). Discrete-event simulation (DES) is one of the techniques typically found in the field of healthcare-operational research that can help with RM. The systematic review pointed to a gap in understanding on how DES can be used for considering explicit resource constraints when performing RM in HTA. Therefore, this research attempts to demonstrate the effects of modelling the constraints, and provide recommendations and guidance for the application of DES-based RM in HTA. This research concluded that incorporating the effects of constraints affects the HTA results, and neglecting those may lead to misleading results and conclusions in HTA. Hence, this study argued the need for simulation-based RM in HTA to perform a more realistic and detail analysis incorporating resource constraints. The researcher then provided recommendations for conducting DES-based RM studies in HTA and also the guidelines for reporting.