title: Incremental net benefit in randomized clinical trials.
abstract: 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.
authors.affiliation: 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
authors.forename: A R
authors.initials: AR
authors.lastname: Willan
authors.forename: D Y
authors.initials: DY
authors.lastname: Lin
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents; D000970:Antineoplastic Agents; D008942:Mitoxantrone; D000638:Amiodarone; D011241:Prednisone