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Assessing Uncertainty in Cost-Effectiveness Analyses

Author

Listed:
  • Giovanni Parmigiani
  • Greg P. Samsa
  • Marek Ancukiewicz
  • Joseph Lipscomb
  • Vic Hasselblad
  • David B. Matchar

Abstract

A framework for quantifying uncertainty about costs, effectiveness measures, and mar ginal cost-effectiveness ratios in complex decision models is presented. This type of application requires special techniques because of the multiple sources of information and the model-based combination of data. The authors discuss two alternative ap proaches, one based on Bayesian inference and the other on resampling. While com putationally intensive, these are flexible in handling complex distributional assumptions and a variety of outcome measures of interest. These concepts are illustrated using a simplified model. Then the extension to a complex decision model using the stroke- prevention policy model is described. Key words: cost-effectiveness analysis; sto chastic models; decision analysis; simulation; stroke; cerebrovascular disease. (Med Decis Making 1997;17:390-401)

Suggested Citation

  • Giovanni Parmigiani & Greg P. Samsa & Marek Ancukiewicz & Joseph Lipscomb & Vic Hasselblad & David B. Matchar, 1997. "Assessing Uncertainty in Cost-Effectiveness Analyses," Medical Decision Making, , vol. 17(4), pages 390-401, October.
    • Handle: RePEc:sae:medema:v:17:y:1997:i:4:p:390-401
    DOI: 10.1177/0272989X9701700404
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    Cited by:

    1. A. E. Ades & Karl Claxton & Mark Sculpher, 2006. "Evidence synthesis, parameter correlation and probabilistic sensitivity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 373-381, April.
    2. Nicola J. Cooper & Alex J. Sutton & Keith R. Abrams & David Turner & Allan Wailoo, 2004. "Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 203-226, March.
    3. David J. Vanness & W. Ray Kim, 2002. "Bayesian estimation, simulation and uncertainty analysis: the cost‐effectiveness of ganciclovir prophylaxis in liver transplantation," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 551-566, September.
    4. Ana P. Johnson-Masotti & Purushottam W. Laud & Raymond G. Hoffmann & Matthew J. Hayat & Steven D. Pinkerton, 2004. "A Bayesian Approach to Net Health Benefits: An Illustration and Application to Modeling HIV Prevention," Medical Decision Making, , vol. 24(6), pages 634-653, November.

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