Hi, I'm Valentyn Litvin

Published and Forthcoming Papers

“Cost-Effectiveness Analysis of Contemporary Advanced Prostate Cancer Treatment Sequences” with Armen Aprikian and Alice Dragomir in Current Oncology, 2025

Advanced prostate cancer has a substantial health impact that has been countered with novel treatments, particularly androgen receptor pathway inhibitors (ARPI). Contemporary research has found ARPIs to provide superior effectiveness in multiple health states, but analogous APRI cost-effectiveness research has only focused on a single health state (i.e. mCSPC) with mixed conclusions. Our contribution is to compare ARPI effectiveness and cost-effectiveness across advanced prostate cancer health states, not just within one health state. To achieve this comparison, our project has the novel feature of modeling and comparing treatment sequences, requiring novel methodological work enabling us to combine trial evidence in sequence.

“Partial Identification of Personalized Treatment Response with Trial-reported Analyses of Binary Subgroups” with Sheyu Li and Charles F. Manski in Epidemiology, 2023

“Precision medicine in cardiorenal and metabolic diseases with routinely collected clinical data: a novel insight”  with Sheyu Li, Qingyang Shi, and Charles F. Manski in Precision Clinical Medicine, 2022

“Evaluating the maximum regret of statistical treatment rules with sample data on treatment response”  with Charles F. Manski in The Stata Journal, 2021

“When ignorance is bliss: Intentional agnosticism in drug approval” in Health Economics, 2019

Working Papers

“The Equitable Quality-Adjusted Life-Year (EQALY)” with Alice Dragomir

Currently, the quality-adjusted life-year (QALY) is a leading measure of health used to compare different treatments in health economic analyses. Although the QALY is useful for analyzing treatments’ health-related quality-of-life (HRQoL) effects, it has faced intellectual and legislative scrutiny due to its potential to unfairly discriminate against disadvantaged patients with lower baseline HRQoL, such as patients with disabilities. However, the currently available alternative measures of LY, evLYG, and HYT all have serious issues, including potential to discriminate against disabled patients. To remedy these issues, I present a novel measure of health called the equitable quality-adjusted life-year (EQALY), which retains the QALY’s ability to compare HRQoL while valuing the health of disadvantaged patients equitably.

“Tried and True or New and Improved?: Using Clinical Guidelines to Balance Innovation and Expertise”

This paper theoretically examines how clinical guidelines should balance treatment effectiveness and provider expertise. A standard goal of evidence-based clinical guidelines is to inform clinicians and encourage them to use the most effective (or cost-effective) treatments for a group of patients. Despite well-documented learning-by-doing effects in clinical practice, there is limited research about how guidelines should account for their influence on clinician expertise. I explore this question theoretically with a model with a social planner choosing a guideline policy for a group of clinicians who learn by doing and treat a heterogeneous patient population. I show that even in an idealized setting with perfect knowledge and aligned cost preferences, clinical guidelines serve a role as skill management policies.  I characterize the social planner's optimal policy as a function of both relative treatment effectiveness and clinicians' learning curves. A key finding is that in some settings, it is optimal for guidelines to recommend a treatment that is less effective on average but is well-practiced. This finding suggests that the prevailing approach of recommending the treatments with superior clinical trial results may harm patients outcomes. 

Contact 

valentyn.litvin [at] umontreal.ca