Statistical cost-effectiveness analysis of two treatments based on net health benefits
Article first published online: 6 APR 2001
Copyright © 2001 John Wiley & Sons, Ltd.
Statistics in Medicine
Volume 20, Issue 8, pages 1279–1302, 30 April 2001
How to Cite
Laska, E. M., Meisner, M., Siegel, C. and Wanderling, J. (2001), Statistical cost-effectiveness analysis of two treatments based on net health benefits. Statist. Med., 20: 1279–1302. doi: 10.1002/sim.774
- Issue published online: 6 APR 2001
- Article first published online: 6 APR 2001
- Manuscript Accepted: MAY 2000
- Manuscript Received: JAN 2000
- U.S. National Institute of Mental Health. Grant Numbers: P50 MH 51359, MH 42959
Statistical methods for cost-effectiveness analysis (CEA) for two treatments that mimic the deterministic optimal rules of CEA are presented. In these rules the objective is to determine the treatment with the maximal effectiveness whose unit cost is less than an amount, λ, that a decision-maker is willing to pay (WTP). This is accomplished by identifying the treatment with the largest positive net health benefit (NHB), which is a function of λ, while controlling the familywise error rate both when the WTP value is given and when it is unspecified. Fieller's theorem is used to determine a region of WTP values where the NHBs of the treatments are not distinguishable. For each λ outside of the confidence region, the larger treatment is identified. A newly developed one-tailed analogue of Fieller's theorem is used to determine the WTP values where a treatment's NHB is positive. The situation in which both treatments are experimental is distinguished from the case where one of the treatments is usual care. The one-tailed confidence region is used in the latter case to obtain the λ values where the NHBs are not different, and determining the region of positivity of the NHBs may be unnecessary. An example is presented in which the cost-effectiveness of two antipsychotic treatments is evaluated. Copyright © 2001 John Wiley & Sons, Ltd.