Projects per year
Abstract
Cost-effectiveness analysis (CEA) in health care is increasingly conducted alongside multicentre and multinational randomised controlled clinical trials (RCTs). The increased use of stochastic CEA is designed to account for between-patient sampling variability in cost-effectiveness data assuming that observations are independently distributed. However, between-location variability in cost-effectiveness may result if there is a hierarchical structure in the data; that is, if there is correlation in costs and outcomes between patients recruited in particular locations. This may be expected in multi-location trials given that centres and countries often differ in factors such as clinical practice, patient case-mix and the unit costs of delivering health care. A failure to acknowledge this feature may lead to misleading conclusions in a trial-based economic study. Multilevel modelling (MLM) is an analytical framework that can be used to handle hierarchical cost-effectiveness data. Using data from a recently conducted economic analysis, this paper shows how multilevel modelling can be used to obtain (a) more appropriate estimates of the population average incremental cost-effectiveness and associated standard errors compared to standard stochastic CEA; and (b) location-specific estimates of incremental cost-effectiveness which can be used to explore appropriately the variability between centres/countries of the cost-effectiveness results. Copyright (c) 2004 John Wiley & Sons, Ltd.
Original language | English |
---|---|
Pages (from-to) | 471-485 |
Number of pages | 15 |
Journal | Health Economics |
Volume | 14 |
Issue number | 5 |
DOIs | |
Publication status | Published - May 2005 |
Keywords
- generalisability
- trial-based cost-effectiveness analysis
- multilevel modelling
- multinational and multi-centre RCTs
- CONFIDENCE-INTERVALS
- EFFECTIVENESS RATIOS
- ECONOMIC-EVALUATION
- RANDOMIZED-TRIAL
- CLINICAL-TRIAL
- HEART-FAILURE
- HYSTERECTOMY
- MULTICENTER
- SIMULATION
- DESIGN
Projects
- 1 Finished
-
Issues in the generalisability of the results of cost-effectiveness analysis conducted using individual level data
1/09/04 → 16/11/07
Project: Research project (funded) › Research