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Cost-minimisation analysis or cost-effectiveness analysis for non-inferiority or equivalence trials and those observing no significant difference in efficacy

Information: Helen Dakin, Sarah Wordsworth

This study is exploring the advantages and disadvantages of conducting full economic evaluations of non-inferiority or equivalence trials and trials observing no significant difference. We are also assessing whether there are any situations where it is appropriate to conduct cost-minimisation analysis (CMA) rather than cost-effectiveness analysis (CEA) or when it may be inefficient to collect economic data. Following the Briggs and O’Brien ‘death of CMA’ paper, we are re-examining the rationale for CMA, focusing on non-inferiority trials and those finding no significant difference in efficacy. We performed a literature search to establish the use of CMA and CEA in recent years and have used simulated data and data from three clinical trials to illustrate the advantages and disadvantages of CMA and explore the potential for biased estimates of cost-effectiveness acceptability curves and the expected value of perfect information (EVPI). A paper on this project was presented at HESG in January 2010.