Reporting the cost-effectiveness of interventions with nonsignificant effect differences: example from a trial of secondary prevention of coronary heart disease

Int J Technol Assess Health Care. 2003 Summer;19(3):476-89. doi: 10.1017/s0266462303000412.

Abstract

Objectives: This study reports the cost-effectiveness of interventions with nonsignificant differences in effect, and considers reporting of cost-effectiveness in situations where nonsignificant differences arise in some but not all end points.

Methods: Data on costs and effects associated with three end points (adequate assessment, risk factors, and life-years) were derived from a trial of methods to promote secondary prevention of coronary heart disease. Incremental cost per life-year gained figures were calculated, and the uncertainty around these was displayed on cost-effectiveness planes in the form of ellipses.

Results: There was a significant difference in one of the intermediate end points (adequate assessment) but nonsignificant differences in the other intermediate end point (risk factors) and the final end point (life-years). Estimation of cost per life-year figures revealed the cost-effectiveness of the interventions to be unfavorable.

Conclusions: Cost-effectiveness ratios based on final end points should be calculated even in situations where nonsignificant differences in life-years arise, to avoid publication bias and to provide decision makers with useful information. Uncertainty in the incremental cost-effectiveness ratios should be estimated and presented graphically.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Coronary Disease / diagnosis
  • Coronary Disease / economics
  • Coronary Disease / prevention & control*
  • Cost of Illness
  • Cost-Benefit Analysis / statistics & numerical data*
  • Data Interpretation, Statistical
  • Female
  • Health Services Research
  • Humans
  • Male
  • Middle Aged
  • Preventive Health Services / economics*
  • Quality-Adjusted Life Years*
  • Risk Factors
  • United Kingdom