IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v15y2006i4p363-372.html
   My bibliography  Save this article

Bayesian cost‐effectiveness analysis with two measures of effectiveness: the cost‐effectiveness acceptability plane

Author

Listed:
  • Miguel A. Negrín
  • Francisco J. Vázquez‐Polo

Abstract

Cost‐effectiveness analysis (CEA) compares the costs and outcomes of two or more technologies. However, there is no consensus about which measure of effectiveness should be used in each analysis. Clinical researchers have to select an appropriate outcome for their purpose, and this choice can have dramatic consequences on the conclusions of their analysis. In this paper we present a Bayesian cost‐effectiveness framework to carry out CEA when more than one measure is considered. In particular, we analyse the case in which two measures of effectiveness, one binary and the other continuous, are considered. Decision‐making measures, such as the incremental cost‐effectiveness ratio, incremental net‐benefit and cost‐effectiveness acceptability curves, are used to compare costs and one measure of outcome. We propose an extension of cost‐acceptability curves, namely the cost‐effectiveness acceptability plane, as a suitable measure for decision taking. The models were validated using data from two clinical trials. In the first one, we compared four highly active antiretroviral treatments applied to asymptomatic HIV patients. As measures of effectiveness, we considered the percentage of patients with undetectable levels of viral load, and changes in quality of life, measured according to EuroQol. In the second clinical trial we compared three methadone maintenance programmes for opioid‐addicted patients. In this case, the measures of effectiveness considered were quality of life, according to the Nottingham Health Profile, and adherence to the treatment, measured as the percentage of patients who participated in the whole treatment programme. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Miguel A. Negrín & Francisco J. Vázquez‐Polo, 2006. "Bayesian cost‐effectiveness analysis with two measures of effectiveness: the cost‐effectiveness acceptability plane," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 363-372, April.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:4:p:363-372
    DOI: 10.1002/hec.1056
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1056
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1056?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    2. Anthony O’Hagan & John W. Stevens, 2001. "Bayesian Assessment of Sample Size for Clinical Trials of Cost-Effectiveness," Medical Decision Making, , vol. 21(3), pages 219-230, May.
    3. Anthony O'Hagan & John W. Stevens, 2001. "A framework for cost‐effectiveness analysis from clinical trial data," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 303-315, June.
    4. Jakob Bjørner & Hans Keiding, 2004. "Cost‐effectiveness with multiple outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1181-1190, December.
    5. Andrew H. Briggs, 1999. "A Bayesian approach to stochastic cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 257-261, May.
    6. Gerald Richardson & Andrea Manca, 2004. "Calculation of quality adjusted life years in the published literature: a review of methodology and transparency," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1203-1210, December.
    7. Daniel F. Heitjan & Alan J. Moskowitz & William Whang, 1999. "Bayesian estimation of cost‐effectiveness ratios from clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 191-201, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Navarro Espigares, José Luis & Hernández Torres, Elisa, 2006. "Health Technologies Assessment: Analysing The Role Of Uncertainty/Evaluación De Tecnologías Sanitarias: Análisis Del Papel De La Incertidumbre," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 24, pages 731-754, Diciembre.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Negri­n, Miguel A. & Vázquez-Polo, Francisco-José, 2008. "Incorporating model uncertainty in cost-effectiveness analysis: A Bayesian model averaging approach," Journal of Health Economics, Elsevier, vol. 27(5), pages 1250-1259, September.
    2. F. J. Vázquez‐Polo & M. A. Negrín Hernández & B. González López‐Valcárcel, 2005. "Using covariates to reduce uncertainty in the economic evaluation of clinical trial data," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 545-557, June.
    3. Elisabeth Fenwick & Bernie J. O'Brien & Andrew Briggs, 2004. "Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 405-415, May.
    4. Francisco-José Polo & Miguel Negrín & Xavier Badía & Montse Roset, 2005. "Bayesian regression models for cost-effectiveness analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 45-52, March.
    5. Karl Claxton & Mark Sculpher & Chris McCabe & Andrew Briggs & Ron Akehurst & Martin Buxton & John Brazier & Tony O'Hagan, 2005. "Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 339-347, April.
    6. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial‐based cost‐effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496, May.
    7. Anthony O’Hagan & John Stevens & Jacques Montmartin, 2000. "Inference for the Cost-Effectiveness Acceptability Curve and Cost-Effectiveness Ratio," PharmacoEconomics, Springer, vol. 17(4), pages 339-349, April.
    8. Richard M. Nixon & David Wonderling & Richard D. Grieve, 2010. "Non‐parametric methods for cost‐effectiveness analysis: the central limit theorem and the bootstrap compared," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 316-333, March.
    9. David J. Vanness & W. Ray Kim, 2002. "Bayesian estimation, simulation and uncertainty analysis: the cost‐effectiveness of ganciclovir prophylaxis in liver transplantation," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 551-566, September.
    10. Simon Eckermann & Andrew R. Willan, 2009. "Globally optimal trial design for local decision making," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 203-216, February.
    11. N. J. Welton & A. E. Ades & D. M. Caldwell & T. J. Peters, 2008. "Research prioritization based on expected value of partial perfect information: a case-study on interventions to increase uptake of breast cancer screening," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(4), pages 807-841.
    12. Andrea Manca & Nigel Rice & Mark J. Sculpher & Andrew H. Briggs, 2005. "Assessing generalisability by location in trial‐based cost‐effectiveness analysis: the use of multilevel models," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 471-485, May.
    13. Mickael Löthgren & Niklas Zethraeus, 2000. "Definition, interpretation and calculation of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 623-630, October.
    14. Carmen Selva-Sevilla & Elena Conde-Montero & Manuel Gerónimo-Pardo, 2020. "Bayesian Regression Model for a Cost-Utility and Cost-Effectiveness Analysis Comparing Punch Grafting Versus Usual Care for the Treatment of Chronic Wounds," IJERPH, MDPI, vol. 17(11), pages 1-21, May.
    15. P. Sendi & A. Gafni & S. Birch, 2002. "Opportunity costs and uncertainty in the economic evaluation of health care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 23-31, January.
    16. Andrew Willan, 2011. "Sample Size Determination for Cost-Effectiveness Trials," PharmacoEconomics, Springer, vol. 29(11), pages 933-949, November.
    17. Theodoros Mantopoulos & Paul M. Mitchell & Nicky J. Welton & Richard McManus & Lazaros Andronis, 2016. "Choice of statistical model for cost-effectiveness analysis and covariate adjustment: empirical application of prominent models and assessment of their results," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 927-938, November.
    18. N. Neymark & I. Adriaenssen & T. Gorlia & S. Caleo & M. Bolla, 2002. "Estimating survival gain for economic evaluations with survival time as principal endpoint: A cost‐effectiveness analysis of adding early hormonal therapy to radiotherapy in patients with locally adva," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 233-248, April.
    19. Douglas Coyle, 2003. "Determining the optimal combinations of mutually exclusive interventions: a response to Hutubessy and colleagues," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 159-162, February.
    20. Anthony O'Hagan & John W. Stevens, 2001. "A framework for cost‐effectiveness analysis from clinical trial data," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 303-315, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:15:y:2006:i:4:p:363-372. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.