Estimating incremental cost-effectiveness ratios and their confidence intervals with different terminating events for survival time and costs

Biostatistics. 2013 Jul;14(3):422-32. doi: 10.1093/biostatistics/kxt002. Epub 2013 Feb 19.

Abstract

Cost-effectiveness analysis (CEA) is an important component of the economic evaluation of new treatment options. In many clinical and observational studies of costs, censored data pose challenges to the CEA. We consider a special situation where the terminating events for the survival time and costs are different. Traditional methods for statistical inference offer no means for dealing with censored data in these circumstances. To address this gap, we propose a new method for deriving the confidence interval for the incremental cost-effectiveness ratio. The simulation studies and real data example show that our method performs very well for some practical settings, revealing a great potential for application to actual settings in which terminating events for the survival time and costs differ.

Keywords: Censored data; Cost-effectiveness analysis; Different terminating events; Fieller method; Survival analysis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Biostatistics
  • Cardiac Resynchronization Therapy / economics
  • Computer Simulation
  • Confidence Intervals
  • Cost-Benefit Analysis / statistics & numerical data*
  • Defibrillators, Implantable / economics
  • Health Care Costs / statistics & numerical data
  • Heart Diseases / mortality
  • Heart Diseases / therapy
  • Heart Failure / prevention & control
  • Humans
  • Randomized Controlled Trials as Topic / statistics & numerical data