ArticlePharmacoEconomics2009
Bayesian modelling of healthcare resource use in multinational randomized clinical trials.
Article in PharmacoEconomics, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The road not taken: transferability issues in multinational trials.PharmacoEconomics · 2013Pooled it
- The cost of drug repurposing: parallel economic evaluation of mirtazapine for severe breathlessness in the multinational BETTER-B trial.BMC health services research · 2025Trial
- The analysis of multinational cost-effectiveness data for reimbursement decisions: a critical appraisal of recent methodological developments.PharmacoEconomics · 2010Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost cost-effectiveness analyses conducted alongside multinational randomized clinical trials (RCT) are carried out applying the unit costs from the country of interest to trial-wide resource use items with the objective of estimating total healthcare costs by treatment group. However, this approach could confound 'price effects' with 'country effects'. An alternative approach is to use multilevel modelling techniques to analyse healthcare resource use (HCRU) from the trial, and obtain country-specific total costs by applying country-specific unit costs to corresponding shrinkage estimates of differential HCRU.
methodsTo illustrate the feasibility of this approach, we analysed data from twin multinational RCTs, which enrolled approximately 2000 individuals into three treatment arms for the management of patients with chronic respiratory disease. The models were implemented using Bayesian multilevel models, to reflect the hierarchical structure of the data while controlling for co-variates at the patient and country level.
resultsThis analysis showed that directly modelling the level of HCRU is a promising approach to facilitate cost-effectiveness analyses conducted alongside multinational RCTs, offering several advantages compared with the modelling of direct costs.
conclusionsIt is argued that modelling the level of HCRU within the Bayesian framework avoids confounding the price effects with the country effects and facilitates the estimation of costs for several countries represented in the trial.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.