Using inverse-weighting in cost-effectiveness analysis with censored data

Due to induced dependent censoring, estimating mean costs and quality-adjusted survival in a cost-effectiveness analysis using standard life-table methods leads to biased results. In this paper we propose methods for estimating the difference in mean costs and the difference in effectiveness, together with their respective variances and covariance in the presence of dependent censoring. We consider the situation in which the measure of effectiveness is either the probability of patients surviving a duration of interest, mean survival time over a duration of interest or mean quality-adjusted survival time over a duration of interest. The method of inverse-weighting is used for censored cost and quality of life data. The methods are illustrated in an example using an incremental net benefit analysis.

[1]  S. Stearns,et al.  Estimating confidence intervals for cost-effectiveness ratios: an example from a randomized trial. , 1996, Statistics in medicine.

[2]  A H Briggs,et al.  Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. , 1997, Health economics.

[3]  A R Willan,et al.  Analysis, sample size, and power for estimating incremental net health benefit from clinical trial data. , 2001, Controlled clinical trials.

[4]  Johan L. Severens,et al.  ECONOMIC EVALUATION OF DIAGNOSTIC TESTS , 1999, International Journal of Technology Assessment in Health Care.

[5]  A H Briggs,et al.  Power and Sample Size Calculations for Stochastic Cost-Effectiveness Analysis , 1998, Medical decision making : an international journal of the Society for Medical Decision Making.

[6]  Frank A. Sloan,et al.  Valuing health care , 1996 .

[7]  D Y Lin,et al.  Incremental net benefit in randomized clinical trials , 2001, Statistics in medicine.

[8]  E. Pulkstenis,et al.  Estimation of mean quality adjusted survival time. , 1999, Statistics in medicine.

[9]  E. Feuer,et al.  Estimating medical costs from incomplete follow-up data. , 1997, Biometrics.

[10]  A H Briggs,et al.  A Bayesian approach to stochastic cost-effectiveness analysis. , 1999, Health economics.

[11]  Testing Equality of Survival Functions of Quality‐Adjusted Lifetime , 2001, Biometrics.

[12]  Andrew R Willan,et al.  Is there a kink in consumers' threshold value for cost-effectiveness in health care? , 2002, Health economics.

[13]  J. Mullahy,et al.  Valuing health care: Statistical issues in cost–effectiveness analyses , 1995 .

[14]  A H Briggs,et al.  Constructing confidence intervals for cost-effectiveness ratios: an evaluation of parametric and non-parametric techniques using Monte Carlo simulation. , 1999, Statistics in medicine.

[15]  A J Moskowitz,et al.  Bayesian estimation of cost-effectiveness ratios from clinical trials. , 1999, Health economics.

[16]  D. Lin,et al.  Linear regression analysis of censored medical costs. , 2000, Biostatistics.

[17]  Morris Meisner,et al.  Power and Sample Size in Cost- Effectiveness Analysis , 1999, Medical decision making : an international journal of the Society for Medical Decision Making.

[18]  D. Heitjan,et al.  Fieller's method and net health benefits. , 2000, Health economics.

[19]  E. M. Konst,et al.  UNCERTAINTY OF INCREMENTAL COST-EFFECTIVENESS RATIOS , 1999, International Journal of Technology Assessment in Health Care.

[20]  C E Phelps,et al.  On the (Near) Equivalence of Cost-Effectiveness and Cost-Benefit Analyses , 1991, International Journal of Technology Assessment in Health Care.

[21]  Anthony O'Hagan,et al.  On estimators of medical costs with censored data. , 2004, Journal of health economics.

[22]  A R Willan,et al.  Cost-effectiveness analysis when the WTA is greater than the WTP. , 2001, Statistics in medicine.

[23]  P. Wakker,et al.  Confidence intervals for cost/effectiveness ratios. , 1995, Health economics.

[24]  Anastasios A. Tsiatis,et al.  A consistent estimator for the distribution of quality adjusted survival time , 1997 .

[25]  J. Hwang,et al.  Estimation of expected quality adjusted survival by cross-sectional survey. , 1996, Statistics in medicine.

[26]  D Polsky,et al.  Confidence intervals for cost-effectiveness ratios: a comparison of four methods. , 1997, Health economics.

[27]  A H Briggs,et al.  Handling uncertainty in economic evaluations of healthcare interventions , 1999, BMJ.

[28]  Anastasios A. Tsiatis,et al.  Estimating medical costs with censored data , 2000 .

[29]  Andrew R. Willan,et al.  Incremental net bene ' t in randomized clinical trials , 2001 .

[30]  M Johannesson,et al.  A Note on Confidence Intervals in Cost-Effectiveness Analysis , 1998, International Journal of Technology Assessment in Health Care.

[31]  R. Baltussen,et al.  The interpretation of results of economic evaluation: explicating the value of health. , 1997, Health economics.

[32]  M J Al,et al.  Costs, effects and C/E-ratios alongside a clinical trial. , 1994, Health economics.

[33]  R. Gelber,et al.  Quality adjusted survival analysis. , 1990, Statistics in medicine.

[34]  J C Gardiner,et al.  Power and sample assessments for tests of hypotheses on cost-effectiveness ratios. , 2000, Health economics.

[35]  J Mullahy.  What you don't know can't hurt you? Statistical issues and standards for medical technology evaluation. , 1996, Medical care.

[36]  A R Willan,et al.  Sample size and power issues in estimating incremental cost-effectiveness ratios from clinical trials data. , 1999, Health economics.

[37]  A Briggs,et al.  Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane. , 1998, Health economics.

[38]  H Zhao,et al.  On Estimating Medical Cost and Incremental Cost‐Effectiveness Ratios with Censored Data , 2001, Biometrics.

[39]  A A Tsiatis,et al.  Efficient Estimation of the Distribution of Quality‐Adjusted Survival Time , 1999, Biometrics.

[40]  Andrew R Willan,et al.  Incremental net benefit in randomized clinical trials with quality‐adjusted survival , 2003, Statistics in medicine.

[41]  J. Heyse,et al.  A regression-based method for estimating mean treatment cost in the presence of right-censoring. , 2000, Biostatistics.

[42]  Robert L. Strawderman,et al.  Estimating the Mean of an Increasing Stochastic Process at a Censored Stopping Time , 2000 .

[43]  A A Stinnett,et al.  Net Health Benefits , 1998, Medical decision making : an international journal of the Society for Medical Decision Making.

[44]  Bernie J. O'Brien,et al.  In Search of Power and Significance: Issues in the Design and Analysis of Stochastic Cost-Effectiveness Studies in Health Care , 1994, Medical care.

[45]  A R Willan,et al.  Confidence intervals for cost-effectiveness ratios: an application of Fieller's theorem. , 1996, Health economics.