PMID: 11921321Mar 29, 2002Paper

Statistical determination of cost-effectiveness frontier based on net health benefits

Health Economics
E M LaskaJoseph Wanderling

Abstract

Statistical methods are given for producing a cost-effectiveness frontier for an arbitrary number of programs. In the deterministic case, the net health benefit (NHB) decision rule is optimal; the rule funds the program with the largest positive NHB at each lambda, the amount a decision-maker is willing to pay for an additional unit of effectiveness. For bivariate normally distributed cost and effectiveness variables and a specified lambda, a statistical procedure is presented, based on the method of constrained multiple comparisons with the best (CMCB), for determining the program with the largest NHB. A one-tailed t test is used to determine if the NHB is positive. To obtain a statistical frontier in the lambda-NHB plane, we develop a method to produce the region in which each program has the largest NHB, by pivoting a CMCB confidence interval. A one-sided version of Fieller's theorem is used to determine the region where the NHB of each program is positive. At each lambda, the pointwise error rate is bounded by a prespecified alpha. Upper bounds on the familywise error rate, the probability of an error at any value of lambda, are given. The methods are applied to a hypothetical clinical trial of antipsychotic agents.

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Apr 17, 2001·Statistics in Medicine·E M LaskaJ Wanderling

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Citations

Apr 21, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Dario GregoriEva Pagano
Apr 15, 2004·Statistics in Medicine·Daniel F HeitjanHuiling Li
Jun 1, 2004·Expert Review of Pharmacoeconomics & Outcomes Research·Jasper M Bos, Maarten J Postma

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