Assessing generalisability by location in trial-based cost-effectiveness analysis: the use of multilevel models

Health Economics
Andrea MancaA Briggs

Abstract

Cost-effectiveness analysis (CEA) in health care is increasingly conducted alongside multicentre and multinational randomised controlled clinical trials (RCTs). The increased use of stochastic CEA is designed to account for between-patient sampling variability in cost-effectiveness data assuming that observations are independently distributed. However, between-location variability in cost-effectiveness may result if there is a hierarchical structure in the data; that is, if there is correlation in costs and outcomes between patients recruited in particular locations. This may be expected in multi-location trials given that centres and countries often differ in factors such as clinical practice, patient case-mix and the unit costs of delivering health care. A failure to acknowledge this feature may lead to misleading conclusions in a trial-based economic study. Multilevel modelling (MLM) is an analytical framework that can be used to handle hierarchical cost-effectiveness data. Using data from a recently conducted economic analysis, this paper shows how multilevel modelling can be used to obtain (a) more appropriate estimates of the population average incremental cost-effectiveness and associated standard errors compared to stan...Continue Reading

References

Jan 1, 1992·International Journal of Technology Assessment in Health Care·M F DrummondK Torfs
Jan 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R RajanM Gent
Sep 1, 1994·Health Economics·B A van HoutF F Rutten
Nov 1, 1996·Health Economics·K Claxton, J Posnett
Feb 18, 1998·Health Economics·N Rice, A Jones
May 5, 1998·Medical Decision Making : an International Journal of the Society for Medical Decision Making·A A Stinnett, J Mullahy
Oct 22, 1998·International Journal of Technology Assessment in Health Care·M TambourM Johannesson
Jun 6, 1996·Journal of Health Services Research & Policy·N Rice, A Leyland
Feb 10, 1983·Journal of Health Economics·F A SloanA B Steinwald
May 29, 1999·Health Economics·A H Briggs
May 28, 2003·Journal of Clinical Epidemiology·Mirjam MoerbeekMartijn P F Berger
Jun 13, 2003·Statistics in Medicine·John R CookJoseph F Heyse

❮ Previous
Next ❯

Citations

Apr 7, 2010·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Raymond OppongUNKNOWN GRACE-01 Study Team
Aug 28, 2013·PharmacoEconomics·Pepijn Vemer, Maureen P M H Rutten-van Mölken
Aug 2, 2006·Annals of the Rheumatic Diseases·Veerle M H CoupéCornelia H M Van den Ende
Jul 21, 2007·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrea MancaNigel Rice
Sep 8, 2007·Cost Effectiveness and Resource Allocation : C/E·Max O BachmannMiranda Mugford
Feb 8, 2006·PharmacoEconomics·Michael Drummond, Mark Sculpher
Sep 28, 2006·PharmacoEconomics·James M Mason, Anne R Mason
Jul 10, 2010·International Journal of Environmental Research and Public Health·Miguel A NegrínFrancisco J Girón
Mar 30, 2010·Complementary Therapies in Clinical Practice·Helen CoxGill Worthy
Feb 20, 2008·Acta Orthopaedica·Lea M DijksmanUNKNOWN International Evidence-Based Orthopaedic Surgery Working Group
Apr 28, 2009·Journal of the American College of Radiology : JACR·Jean-Eric TarrideRon Goeree
Feb 5, 2008·Psychiatry Research·I Hui LeeChing Lin Chu
Aug 5, 2008·Health Economics·Fernando AntonanzasMariola Pinillos
Dec 28, 2006·Health Economics·Richard GrieveJohn Cairns
Nov 11, 2009·Statistics in Medicine·Paola BerchiallaDario Gregori
Apr 25, 2014·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Peter MakaiIsabelle Fabbricotti
Nov 11, 2009·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Michael DrummondJohan Severens
Sep 12, 2006·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Frank M TortiKevin A Schulman
Jul 24, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Michele PetrincoDario Gregori
Sep 12, 2009·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·William F McGhanDonna Rindress
Jun 1, 2006·Expert Review of Pharmacoeconomics & Outcomes Research·Andrew R Willan
Feb 7, 2015·Statistical Methods in Medical Research·Md Abu ManjuMartijn Pf Berger
Apr 17, 2015·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Christian E H Boehler, Joanne Lord
Aug 14, 2009·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Richard GrieveSimon G Thompson
Jun 19, 2009·Medical Care·Deborah A Marshall, Margaret Hux
Oct 19, 2007·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Xin Sun, Thomas Faunce
Feb 24, 2006·Health Economics·Mark J SculpherChris McCabe
Oct 19, 2010·Expert Review of Pharmacoeconomics & Outcomes Research·Christian Weber

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.