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Economic Analysis Alongside Clinical Trials: Revisiting the Methodological Issues

Published online by Cambridge University Press:  10 March 2009

Michael F. Drummond  and
Linda Davies
Michael F. Drummond
Affiliation:
University of York
Linda Davies
Affiliation:
University of Birmingham
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Abstract

Controlled clinical trials are recognized as the best source of data on the efficacy of health care interventions and technologies. Because economic evaluation is dependent on the quality of the underlying medical evidence, clinical trials have increasingly been viewed as a natural vehicle for economic analysis. However, the closer integration of economic and clinical research raises many methodological issues. This paper discusses these issues in trial design, collection of resource use data, collection of outcome data, and interpretation and extrapolation of results. Some guidelines are suggested for economic analysts wishing to undertake evaluations alongside clinical trials.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Issue 4 , Fall 1991 , pp. 561 - 573
Copyright
Copyright © Cambridge University Press 1991

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References

1.Banta, H. D., Behney, C. J., Willems, J. S.Toward rational technology in medicine. New York: Springer, 1981.Google ScholarPubMed
2.Bergner, M., et al. The Sickness Impact Profile: Conceptual formulation and methodology for the development of a health status measure. International Journal of Health Services, 1976, 6, 478–507.CrossRefGoogle ScholarPubMed
3.Brady, F. B.A singular view. Maryland: Frank B. Brady, 1985.Google Scholar
4.Collins, R., Peto, R., MacMahon, S., et al. Blood pressure, stroke and coronary heart dis ease: Part 2, Short term reductions in blood pressure: Overview of randomized drug trials in their epidemiological context. Lancet, 1990, 335, ii, 827–38.CrossRefGoogle Scholar
5.Drummond, M. F. (ed.). Economic appraisal of health technology in the European Community. Oxford, UK.: Oxford University Press, 1987.Google Scholar
6.Drummond, M. F.Resource allocation decisions in health care: A role for quality of life assessments? Journal of Chronic Diseases, 1987, 40, 605–16.Google Scholar
7.Drummond, M. F., & Davies, L. M.AIDS: The challenge for economic analysis. Birmingham, U.K.: Health Services Management Centre in collaboration with the World Health Organization (Regional Office for Europe).Google Scholar
8.Drummond, M. F., Mohide, E. A., Tew, M., et al. Economic evaluation of a support program for caregivers of demented elderly. International Journal of Technology Assessment in Health Care, 1991, 7, 209–19.CrossRefGoogle ScholarPubMed
9.Drummond, M. F., & Stoddart, G. L.Economic analysis and clinical trials. Controlled Clinical Trials, 1984, 5, 115–28.Google Scholar
10.Drummond, M. F., Teeling Smith, G., & Wells, N.Economic evaluation in the development of medicines. London: Office of Health Economics, 1988.Google Scholar
11.Eisenberg, J. M., Glick, H., & Koffer, H. Pharmacoeconomics: Economic evaluation of Pharmaceuticals. In Strom, B. (ed.), Pharmacoepidemiology. New York: Churchill Livingston, 1989.Google Scholar
12.Evans, R. G., & Robinson, G. C.Surgical day care: Measurements of the economic payoff. Canadian Medical Association Journal, 1980, 123, 873–80.Google Scholar
13.Feeny, D., Labelle, R., & Torrance, G. W. Integrating economic evaluations and quality of life assessment. In Spilker, B. (ed.), Quality of life assessments in clinical trials. New York: Raven, 1990, 71–83.Google Scholar
14.Feeny, D., & Torrance, G. W. Incorporating utility-based quality-of-life assessment measures in clinical trials: Two examples. CHEPA Working Paper No. 12. Hamilton, Ontario: Centre for Health Economics and Policy Analysis, McMaster University, 1989.Google Scholar
15.Finkler, S. A.The distinction between costs and charges. Annals of Internal Medicine, 1982, 96, 102–09.CrossRefGoogle Scholar
16.Gudex, C., & Kind, P. The QALY toolkit. Centre for Health Economics/Health Economics Consortium Discussion Paper 38. University of York, 1987.Google Scholar
17.Haan, G. H. G., & Rutten, F. F. H. Economic appraisal, health service planning and budgetary management for health technologies. In Drummond, M. F. (ed.), Economic appraisal of health technology in the European Community. Oxford, U.K.: Oxford University Press, 1987, 135–46.Google Scholar
18.Hull, R. D., Hirsh, J., Sackett, D. L., & Stoddart, G. L.Cost-effectiveness of clinical diagnosis, venography and noninvasive testing in patients with symptomatic deep-vein thrombosis. New England Journal of Medicine, 1981, 304, 1561–67.CrossRefGoogle ScholarPubMed
19.Hunt, S. M., McEwen, J., & McKenna, S. P.Measuring health status. London: Croom Helm, 1986.Google Scholar
20.ISIS. ISIS 3 protocol. Oxford, U.K.: Oxford, 1989.Google Scholar
21.Karnofsky, D. A., & Burchenal, J. H. The clinical evaluation of chemotherapeutic agents in cancer. In Mcleod, C. M. (ed.), Evaluation of therapeutic agents. New York: Columbia University Press, 1949.Google Scholar
22.Katz, S.The science of quality of life. Journal of Chronic Diseases, 1987, 40, 459–63.Google Scholar
23.Kind, P., Rosser, R. M., & Williams, A. H. Valuation of quality of life: Some psychometric evidence. In Jones-lee, M. W. (ed.), The value of life and safety. Amsterdam: North-Holland, 1982, 157–70.Google Scholar
24.L'Abbe, K. A., Detsky, A. S., & O'Rourke, E.Meta-analysis in clinical research. Annals of Internal Medicine, 1987, 107, 224–33.Google Scholar
25.Meherez, A., & Gafni, A.Quality adjusted life years, utility theory and healthy years equivalents. Medical Decision Making, 1989, 9, 142–49.Google Scholar
26.Mugford, M., Drummond, M. F., Henderson, J., et al. Chorionic villus sampling (letter). Lancet, 1985, ii, 384–85.CrossRefGoogle Scholar
27.Parkin, D. M., McGuire, A., & Yule, B.Aggregate health care expenditures and national income: Is health care a luxury good? Journal of Health Economics, 1987, 6, 89–163.Google Scholar
28.Shapiro, M., Schoenbaum, S. C., Tager, I. B., et al. Cost benefit analysis of anti-microbial prophylaxis in abdominal and vaginal hysterectomy. Journal of the American Medical Association, 1983, 249, 1290–94.CrossRefGoogle Scholar
29.Thompson, M. S., & Cohen, A. B. Should we measure personal valuations of perinatal outcomes? In Sinclair, J. C. (ed.), Clinical and economic evaluation of perinatal programmes. Proceedings of Mead Johnson Symposium on Perinatal and Developmental Medicine, Vail, CO, 1982, 47–52.Google Scholar
30.Thompson, M. S., Read, J. L., Hutchings, H. C., & Harris, E. D.The cost-effectiveness of auranofin: Results of a randomized clinical trial. Journal of Rheumatology, 1988, 15, 35–42.Google ScholarPubMed
31.Torrance, G. W.Utility approach to measuring health-related quality of life. Journal of Chronic Diseases, 1987, 40, 593–600.Google Scholar
32.Torrance, G. W., Boyle, M. H., & Horwood, S. P.Application of multi-attribute utility theory to measure social preferences for health states. Operations Research, 1982, 30, 1043–69.CrossRefGoogle ScholarPubMed
33.Torrance, G. M., & Feeny, D.Utilities and quality-adjusted life years. International Journal of Technology Assessment in Health Care, 1989, 5, 559–75.Google Scholar
34.Torrance, G. W., & Zipursky, A.Cost-effectiveness of antepartum prevention of Rh immunization. Clinics in Perinatology, 1984, 11, 267–81.CrossRefGoogle ScholarPubMed
35.Williams, A. H.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed