Estimating incremental cost-effectiveness ratios and their confidence intervals with differentially censored data.
With medical costs escalating over recent years, cost analysis is being conducted more and more to assess economic impact of new treatment options. An incremental cost-effectiveness ratio (ICER) is a measure that assesses the additional cost for a new treatment for each additional unit of effectiveness, such as saving 1 year of life. In this article, we consider cost-effectiveness analysis for new treatments evaluated in a randomized clinical trial setting with staggered entries. In particular, the censoring times are different for cost and survival data. We propose a method for estimating the ICER and obtaining its confidence interval when differential censoring exists. Simulation experiments are conducted to evaluate our proposed method. We also apply our methods to a clinical trial example comparing the cost-effectiveness of implanted defibrillators with conventional therapy for individuals with reduced left ventricular function after myocardial infarction.
Wang
Hongkun
H
Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia 22908, USA. hkwang@virginia.edu
Zhao
Hongwei
H
D001699:Biometry; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D017147:Defibrillators, Implantable / Q000191:economics; D006801:Humans; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000150:complications; D016032:Randomized Controlled Trials as Topic / Q000191:economics* / Q000706:statistics & numerical data; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000191:economics / Q000209:etiology / Q000401:mortality / Q000628:therapy