Document Detail

'Lost in translation': accounting for between-country differences in the analysis of multinational cost-effectiveness data.
MedLine Citation:
PMID:  17067195     Owner:  NLM     Status:  MEDLINE    
Cost-effectiveness analysis has gained status over the last 15 years as an important tool for assisting resource allocation decisions in a budget-limited environment such as healthcare. Randomised (multicentre) multinational controlled trials are often the main vehicle for collecting primary patient-level information on resource use, cost and clinical effectiveness associated with alternative treatment strategies. However, trial-wide cost effectiveness results may not be directly applicable to any one of the countries that participate in a multinational trial, requiring some form of additional modelling to customise the results to the country of interest. This article proposes an algorithm to assist with the choice of the appropriate analytical strategy when facing the task of adapting the study results from one country to another. The algorithm considers different scenarios characterised by: (a) whether the country of interest participated in the trial; and (b) whether individual patient-level data (IPD) from the trial are available. The analytical options available range from the use of regression-based techniques to the application of decision-analytic models. Decision models are typically used when the evidence base is available exclusively in summary format whereas regression-based methods are used mainly when the country of interest actively recruited patients into the trial and there is access to IPD (or at least country-specific summary data). Whichever method is used to reflect between-country variability in cost-effectiveness data, it is important to be transparent regarding the assumptions made in the analysis and (where possible) assess their impact on the study results.
Andrea Manca; Andrew R Willan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  PharmacoEconomics     Volume:  24     ISSN:  1170-7690     ISO Abbreviation:  Pharmacoeconomics     Publication Date:  2006  
Date Detail:
Created Date:  2006-10-27     Completed Date:  2007-01-26     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9212404     Medline TA:  Pharmacoeconomics     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  1101-19     Citation Subset:  T    
Centre for Health Economics, University of York, York, England.
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MeSH Terms
Cost-Benefit Analysis / statistics & numerical data*
Economics, Pharmaceutical / standards*
International Cooperation
Grant Support
GR07130MA//Wellcome Trust

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