Incremental net benefit in randomized clinical trials.
There are three approaches to health economic evaluation for comparing two therapies. These are (i) cost minimization, in which one assumes or observes no difference in effectiveness, (ii) incremental cost-effectiveness, and (iii) incremental net benefit. The latter can be expressed either in units of effectiveness or costs. When analysing data from a clinical trial, expressing incremental net benefit in units of cost allows the investigator to examine all three approaches in a single graph, complete with the corresponding statistical inferences. Furthermore, if costs and effectiveness are not censored, this can be achieved using common two-sample statistical procedures. The above will be illustrated using two examples, one with censoring and one without.
Willan
A R
AR
Department of Clinical Epidemiology and Biostatistics, McMaster University and Centre for Evaluation of Medicines, St Joseph's Hospital, 600-143 James Street South, Hamilton, ON, L8P 3A1, Canada. willana@mcmaster.ca
Lin
D Y
DY
D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods; D017147:Defibrillators, Implantable; D006323:Heart Arrest / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008297:Male; D008942:Mitoxantrone / Q000627:therapeutic use; D015233:Models, Statistical; D011241:Prednisone / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic / Q000191:economics* / Q000379:methods
D000889:Anti-Arrhythmia Agents; D000970:Antineoplastic Agents; D008942:Mitoxantrone; D000638:Amiodarone; D011241:Prednisone