The Analysis of Multinational Cost-Effectiveness Data for Reimbursement Decisions: A Critical Appraisal of Recent Methodological Developments
AbstractEvidence produced by multinational trial-based cost-effectiveness studies is often used to inform decisions concerning the adoption of new healthcare technologies. A key issue relating to the use of this type of evidence is the extent to which trial-wide economic results are applicable to every single country participating in the study. We consider what role cost-effectiveness analysis alongside multinational trials should have in assisting reimbursement decisions at jurisdiction and national levels. Using the proposed framework as a benchmark to evaluate their relative pros and cons, we then describe and review the statistical approaches used in the multinational trial-based cost-effectiveness literature. The results of the review are used to define the desirable characteristics a statistical method for the analysis of data collected from different jurisdictions should have in order to be consistent with the proposed framework. It is argued that Bayesian hierarchical models that use both patient- and country-level information are the most appropriate tool to analyse multinational trial-based cost-effectiveness data and facilitate the between-country generalizability assessment of the study findings. The merits of each approach are discussed, highlighting problems and limitations, in order to identify areas of future research.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoArticle provided by Springer Healthcare | Adis in its journal PharmacoEconomics.
Volume (Year): 28 (2010)
Issue (Month): 12 ()
Contact details of provider:
Web page: http://pharmacoeconomics.adisonline.com/
Bayesian-analysis; Clinical-trial-design; Cost-effectiveness; Statistics.;
Find related papers by JEL classification:
- C - Mathematical and Quantitative Methods
- D - Microeconomics
- I - Health, Education, and Welfare
- Z - Other Special Topics
- I1 - Health, Education, and Welfare - - Health
- I19 - Health, Education, and Welfare - - Health - - - Other
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Moreno, E. & Girón, F.J. & Martínez, M.L. & Vázquez-Polo, F.J. & Negrín, M.A., 2013. "Optimal treatments in cost-effectiveness analysis in the presence of covariates: Improving patient subgroup definition," European Journal of Operational Research, Elsevier, vol. 226(1), pages 173-182.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin).
If references are entirely missing, you can add them using this form.