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Measuring and illustrating statistical evidence in a cost-effectiveness analysis

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  • Hoch, Jeffrey S.
  • Blume, Jeffrey D.

Abstract

Recently, there has been much interest in using the cost-effectiveness acceptability curve (CEAC) to measure the statistical evidence of cost-effectiveness. The CEAC has two well established but fundamentally different interpretations: one frequentist and one Bayesian. As an alternative, we suggest characterizing the statistical evidence about cost-effectiveness using the likelihood function (the key element of both approaches). Its interpretation is neither dependent on the sample space nor on the prior distribution. Moreover, the probability of observing misleading evidence is low and controllable, so this approach is justifiable in the traditional sense of frequentist long-run behaviour. We propose a new graphic for displaying the evidence about cost-effectiveness and explore the strengths of likelihood methods using data from an economic evaluation of a Program in Assertive Community Treatment (PACT).

Suggested Citation

  • Hoch, Jeffrey S. & Blume, Jeffrey D., 2008. "Measuring and illustrating statistical evidence in a cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 27(2), pages 476-495, March.
  • Handle: RePEc:eee:jhecon:v:27:y:2008:i:2:p:476-495
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    3. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
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    5. Richard Royall & Tsung‐Shan Tsou, 2003. "Interpreting statistical evidence by using imperfect models: robust adjusted likelihood functions," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 65(2), pages 391-404, May.
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    7. Jeffrey S. Hoch & Andrew H. Briggs & Andrew R. Willan, 2002. "Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 415-430, July.
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    10. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Dirk Müller & Eleanor Pullenayegum & Afschin Gandjour, 2015. "Impact of small study bias on cost-effectiveness acceptability curves and value of information analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 219-223, March.

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