Cost-effectiveness analysis alongside multinational clinical trials
International cost-effectiveness studies which collect data from a variety of countries are becoming increasingly available and are part of the research agenda of organisations such as the Medical Research Council, the Department of Health and the pharmaceutical industry. Collecting data from different countries increases the sample size to answer a particular research question, but also poses new problems for researchers. Standard methods to report cost-effectiveness analysis assume the data is location-specific.
To further develop the methodology of multinational cost-effectiveness studies, Oliver Rivero-Arias completed a doctoral thesis funded by a NIHR Doctoral Fellowship in 2010. His purpose in this work was to review current analytical methods for the economic evaluation of multinational clinical trials and place them in the context of microeconomic theory, looking especially at principles of production and relative factor prices.
HERC is involved in a number of trials where these methodological issues arise. ISAT, the International Subarachnoid Aneurysm Trial has produced a large multinational resource use and outcomes dataset from which we are performing the economic evaluation of endovascular coiling compared to neurosurgery for patients with aneurysmal subarachnoid haemorrhage. ART, the Arterial Revascularisation Trial is a 10-year trial of different techniques for coronary artery bypass, which is being conducted in several European countries and Australia, and for which methods for handling the multinational economic data will need to be explored.
Rivero-Arias and Gray, The multinational nature of cost-effectiveness analyses alongside multinational clinical trials. Value in Health2010; 13(1):34-41, 2010
Economic issues in multinational cost-effectiveness analyses – a simulation study. Seminar presented at the Health Economics Unit, University of Birmingham, October 2011, Birmingham.
Economic issues in multinational cost-effectiveness analyses – a simulation study. Seminar presented at Oxford Outcomes Ltd., July 2011, Oxford.
Rivero-Arias O and Gray A, The multinational nature of cost-effectiveness analyses alongside multinational clinical trials. 7th International Health Economics Association Conference (iHEA), July 2009, Beijing.
Rivero-Arias O, Wolstenholme J, Gray A, Tok MY. Building an economic model using data from a large multinational randomised controlled trial to extrapolate the results from the within trial analysis. 6th International Health Economics Association Conference (iHEA), July 2007, Copenhagen.
Rivero-Arias O, Wolstenholme J, Gray A on behalf of the ISAT study. Analysing and reporting resource-use and outcome measures in multi-country studies: a comparison of methods. 5th International Health Economics Association Conference (iHEA), July 2005, Barcelona.