Economic evaluation in the context of multimorbidity: a systematic review and cost-consequence analysis

Multimorbidity—the co-occurrence of two or more chronic diseases, where one condition is not necessarily more important than the other(s)—is a significant global healthcare issue. This thesis examines interventions for multimorbidity in the context of economic evaluation and comprises (i) a systematic review assessing the cost-effectiveness of interventions targeted to people with multimorbidity and (ii) a cost-consequence analysis, performed alongside a randomized controlled trial, comparing an interactive digital health-based self-management program for people with multimorbidity with usual care. The review, consisting of 17 economic evaluations, highlighted variation in the methods used to assess cost-effectiveness, including the choice of study design and the valuation of outcomes. Overall, a finding from the review was that interventions with self-management components were often shown to be cost saving, a conclusion that was also supported in the trial-based cost-consequence analysis (albeit with the caveat that some key resources were not costed in the analysis).