Average Cost-Effectiveness Ratio with Censored Data

• Activity Number: 283
• Type: Topic Contributed
• Date/Time: Tuesday, July 31, 2012 : 8:30 AM to 10:20 AM
• Sponsor: Health Policy Statistics Section
• Author(s): Heejung Bang*+ and Hongwei Zhao
• Companies: University of California at Davis and Texas A&M University
• Keywords: Bootstrap ; Confidence Interval ; Fieller ; Taylor

Abstract

In the cost-effectiveness analysis, interest could lie foremost in the incremental cost-effectiveness ratio (ICER) which is the ratio of the incremental cost to the incremental benefit of two competing interventions. The average cost-effectiveness ratio (ACER) is the ratio of the cost to benefit of an intervention without reference to a comparator. A vast literature is available for statistical inference of the ICERs, but limited methods have been developed for the ACERs, particularly in the presence of censoring. Censoring is a common feature in prospective studies and valid analyses should properly adjust for censoring in cost as well as in effectiveness. In this talk, I will present statistical methods for constructing a confidence interval for the ACER from censored data. Different methods - Fieller, Taylor, Bootstrap - are proposed and through simulation studies and data analysis, the performance characteristics of these methods are addressed.