THE HYPOTHETICAL SCENARIO-BASED COMPARATIVE ASSESSMENT (SCAN) MODEL: EVALUATING HEALTHCARE RESOURCE UTILISATION ACROSS TREATMENT STRATEGIES FOR REFRACTORY OR UNEXPLAINED CHRONIC COUGH
Author(s)
Zizi Elsisi, PhD1, Ru HAN, PhD2, Emir Gürsel, MS1, George Nikitas, PhD3, Erin Arthurs, MS4, Suvapun Bunniran, PhD5, Soham Shukla, MS, PharmD6, Sumeyye Samur, PhD1, Turgay Ayer, PhD1.
1Value Analytics Labs, Boston, MA, USA, 2GSK, Wavre, Belgium, 3GSK, Athens, Greece, 4GSK, Mississauga, ON, Canada, 5GSK, Collegeville, PA, USA, 6GSK, Englewood, NJ, USA.
1Value Analytics Labs, Boston, MA, USA, 2GSK, Wavre, Belgium, 3GSK, Athens, Greece, 4GSK, Mississauga, ON, Canada, 5GSK, Collegeville, PA, USA, 6GSK, Englewood, NJ, USA.
OBJECTIVES: Patients with refractory or unexplained chronic cough (RCC/UCC) experience prolonged diagnostic journeys and fragmented care pathways, partly due to a lack of approved treatments specifically targeting RCC/UCC. We aimed to evaluate how alternative placements of a hypothetical selective P2X3 receptor antagonist may influence downstream healthcare resource utilisation (HCRU) from a US payer perspective.
METHODS: We developed the Scenario-based Comparative AssessmeNt (SCAN) model, a hybrid decision-analytic framework, to evaluate exploratory placement strategies for a P2X3 receptor antagonist, varying in timing and sequencing. These scenarios were compared with standard care within the American College of Chest Physicians (CHEST) guidelines. SCAN comprised a short-term decision tree and a long-term Markov model. The decision tree captured diagnostic evaluation and empiric management of common treatable causes of chronic cough, and subsequent investigations. Patients diagnosed with RCC/UCC then transitioned to the Markov model, which simulated long-term disease progression and outcomes. Key inputs included treatment response and discontinuation, sourced from clinical literature. HCRU outcomes (physician visits, specialist visits, diagnostic tests and HCRU costs excluding non-RCC/UCC lifetime costs) were evaluated per 1000 patients over a lifetime horizon. Results are reported as ranges across the explored strategies.
RESULTS: Per 1000 patients, intervention placement strategies were associated with reductions across all HCRU outcomes. Specifically, primary care visits decreased by 13--25% (476--953 primary care visits avoided), specialist visits decreased by 23--47% (1263--2582 avoided) and diagnostic tests decreased by 3--13% (71--262 avoided). Diagnostic and RCC/UCC-related HCRU lifetime costs decreased by 6--10%, corresponding to $268,974--$411,227 avoided per 1000 patients.
CONCLUSIONS: The SCAN model suggests that despite a modest hypothetical scenario efficacy of 2.5%, alternative placements of a conceptual selective P2X3 receptor antagonist within the CHEST-aligned chronic cough pathway may meaningfully reduce downstream HCRU, addressing a large unmet need, and provide a transparent, payer-relevant framework to evaluate these effects.
METHODS: We developed the Scenario-based Comparative AssessmeNt (SCAN) model, a hybrid decision-analytic framework, to evaluate exploratory placement strategies for a P2X3 receptor antagonist, varying in timing and sequencing. These scenarios were compared with standard care within the American College of Chest Physicians (CHEST) guidelines. SCAN comprised a short-term decision tree and a long-term Markov model. The decision tree captured diagnostic evaluation and empiric management of common treatable causes of chronic cough, and subsequent investigations. Patients diagnosed with RCC/UCC then transitioned to the Markov model, which simulated long-term disease progression and outcomes. Key inputs included treatment response and discontinuation, sourced from clinical literature. HCRU outcomes (physician visits, specialist visits, diagnostic tests and HCRU costs excluding non-RCC/UCC lifetime costs) were evaluated per 1000 patients over a lifetime horizon. Results are reported as ranges across the explored strategies.
RESULTS: Per 1000 patients, intervention placement strategies were associated with reductions across all HCRU outcomes. Specifically, primary care visits decreased by 13--25% (476--953 primary care visits avoided), specialist visits decreased by 23--47% (1263--2582 avoided) and diagnostic tests decreased by 3--13% (71--262 avoided). Diagnostic and RCC/UCC-related HCRU lifetime costs decreased by 6--10%, corresponding to $268,974--$411,227 avoided per 1000 patients.
CONCLUSIONS: The SCAN model suggests that despite a modest hypothetical scenario efficacy of 2.5%, alternative placements of a conceptual selective P2X3 receptor antagonist within the CHEST-aligned chronic cough pathway may meaningfully reduce downstream HCRU, addressing a large unmet need, and provide a transparent, payer-relevant framework to evaluate these effects.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE668
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Thresholds & Opportunity Cost
Disease
Neurological Disorders, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)