Assessing the appropriateness of combining economic data from multinational clinical trials.
Because of the potential for large variability among countries in the utilization and cost of health care resources, it is important to assess the appropriateness of combining economic data across the countries in a multinational clinical economic trial. We show how available tests for interaction can be applied to economic endpoints, including cost-effectiveness ratios and net health benefits. This analysis includes a characterization of possible interactions being quantitative or qualitative in nature. In the absence of interaction, a pooled estimate of the economic endpoint should be representative of the participating countries. We explore the analytic issues by further analysing data from the Scandinavian Simvastatin Survival Study (4S).
Cook
John R
JR
Health Economic Statistics, Merck Research Laboratories, UN-A102, West Point, PA 19486, U.S.A.
Drummond
Michael
M
Glick
Henry
H
Heyse
Joseph F
JF
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D017048:Health Care Costs; D006801:Humans; D015337:Multicenter Studies as Topic / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000191:economics / Q000379:methods*; D012537:Scandinavian and Nordic Countries; D019821:Simvastatin / Q000627:therapeutic use
D000924:Anticholesteremic Agents; D019821:Simvastatin