title: Estimating incremental cost-effectiveness ratios and their confidence intervals with differentially censored data.
abstract: 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.
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia 22908, USA. hkwang@virginia.edu
authors.forename: Hongkun
authors.initials: H
authors.lastname: Wang
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhao
mesh_terms: 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