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Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT‐3 economic analysis

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  • Andrew R. Willan
  • Eleanor M. Pinto
  • Bernie J. O'Brien
  • Padma Kaul
  • Ron Goeree
  • Larry Lynd
  • Paul W. Armstrong

Abstract

The growing number of multinational clinical trials in which patient‐level health care resource data are collected have raised the issue of which is the best approach for making inference for individual countries with respect to the between‐treatment difference in mean cost. We describe and discuss the relative merits of three approaches. The first uses the random effects pooled estimate from all countries to estimate the difference for any particular country. The second approach estimates the difference using only the data from the specific country in question. Using empirical Bayes estimation a third approach estimates the country‐specific difference using a variance‐weighted linear sum of the estimates provided by the other two approaches. The approaches are illustrated and compared using the data from the ASSENT‐3 trial. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Andrew R. Willan & Eleanor M. Pinto & Bernie J. O'Brien & Padma Kaul & Ron Goeree & Larry Lynd & Paul W. Armstrong, 2005. "Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT‐3 economic analysis," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 327-338, April.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:4:p:327-338
    DOI: 10.1002/hec.969
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    References listed on IDEAS

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    1. Kevin Schulman & Jennifer Burke & Michael Drummond & Linda Davies & Per Carlsson & Jans Gruger & Anthony Harris & Carlo Lucioni & Ramon Gisbert & Ted Llana & Eric Tom & Bernard Bloom & Richard Willke , 1998. "Resource costing for multinational neurologic clinical trials: methods and results," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 629-638, November.
    2. Andrew H. Briggs & Bernie J. O'Brien, 2001. "The death of cost‐minimization analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 179-184, March.
    3. Richard J. Willke & Henry A. Glick & Daniel Polsky & Kevin Schulman, 1998. "Estimating country‐specific cost‐effectiveness from multinational clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 481-493, September.
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    1. Mark J. Sculpher & Karl Claxton & Mike Drummond & Chris McCabe, 2006. "Whither trial‐based economic evaluation for health care decision making?," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 677-687, July.
    2. Eleanor M. Pullenayegum & Kelly M. Sunderland & Jeffrey A. Johnson & Feng Xie, 2017. "Handling Regional Variation in Health State Preferences within a Country," Medical Decision Making, , vol. 37(3), pages 252-261, April.
    3. Felix Achana & Daniel Gallacher & Raymond Oppong & Sungwook Kim & Stavros Petrou & James Mason & Michael Crowther, 2021. "Multivariate Generalized Linear Mixed-Effects Models for the Analysis of Clinical Trial–Based Cost-Effectiveness Data," Medical Decision Making, , vol. 41(6), pages 667-684, August.
    4. Richard Grieve & John Cairns & Simon G. Thompson, 2010. "Improving costing methods in multicentre economic evaluation: the use of multiple imputation for unit costs," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 939-954, August.
    5. Kelvin K. W. Chan & Feng Xie & Andrew R. Willan & Eleanor M. Pullenayegum, 2018. "Conducting EQ-5D Valuation Studies in Resource-Constrained Countries: The Potential Use of Shrinkage Estimators to Reduce Sample Size," Medical Decision Making, , vol. 38(1), pages 26-33, January.
    6. Andrea Manca & Paul C. Lambert & Mark Sculpher & Nigel Rice, 2007. "Cost-Effectiveness Analysis Using Data from Multinational Trials: The Use of Bivariate Hierarchical Modeling," Medical Decision Making, , vol. 27(4), pages 471-490, July.
    7. Christian E. H. Boehler & Joanne Lord, 2016. "Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries," Medical Decision Making, , vol. 36(1), pages 31-47, January.
    8. Andrew R. Willan & Simon Eckermann, 2012. "Accounting For Between‐Study Variation In Incremental Net Benefit In Value Of Information Methodology," Health Economics, John Wiley & Sons, Ltd., vol. 21(10), pages 1183-1195, October.
    9. Andrew R. Willan & Matthew E. Kowgier, 2008. "Cost‐effectiveness analysis of a multinational RCT with a binary measure of effectiveness and an interacting covariate," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 777-791, July.

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