Healthcare Economist December 22, 2025
That is the title of a helpful article by Karnon and Haji Ali Afzali (Pharmacoeconomics 2014) with a subtitle A Review and Critique of the Costs and Benefits of DES.
The paper starts by highlighting the 3 most common types of models: decision trees, Markovian cohort models, and individual level models. Decisions trees are useful for simple, short-term models, but not useful for more complex modeling tasks or longer time horizons. Cohort models are the most popular, but “…[b]ecause such models follow a cohort rather than individuals, they are subject to the Markovian assumption, which states that the subsequent (or future) pathway of an object depends only upon the present health state, not on the sequence of states that preceded...
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