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Bayesian estimation of cost-effectiveness ratios from clinical trials

✍ Scribed by Daniel F. Heitjan; Alan J. Moskowitz; William Whang

Publisher
John Wiley and Sons
Year
1999
Tongue
English
Weight
194 KB
Volume
8
Category
Article
ISSN
1057-9230

No coin nor oath required. For personal study only.

✦ Synopsis

Estimation of the incremental cost-effectiveness ratio (ICER) is difficult for several reasons: treatments that decrease both cost and effectiveness and treatments that increase both cost and effectiveness can yield identical values of the ICER; the ICER is a discontinuous function of the mean difference in effectiveness; and the standard estimate of the ICER is a ratio. To address these difficulties, we have developed a Bayesian methodology that involves computing posterior probabilities for the four quadrants and separate interval estimates of ICER for the quadrants of interest. We compute these quantities by simulating draws from the posterior distribution of the cost and effectiveness parameters and tabulating the appropriate posterior probabilities and quantiles. We demonstrate the method by re-analysing three previously published clinical trials.

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