A Bayesian approach to stochastic cost-effectiveness analysis

Briggs, A. (2001) A Bayesian approach to stochastic cost-effectiveness analysis. International Journal of Technology Assessment in Health Care, 17(1), pp. 69-82.

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Abstract

The aim of this paper is to discuss the use of Bayesian methods in cost-effectiveness analysis (CEA) and the common ground between Bayesian and traditional frequentist approaches. A further aim is to explore the use of the net benefit statistic and its advantages over the incremental cost-effectiveness ratio (ICER) statistic. In particular, the use of cost-effectiveness acceptability curves is examined as a device for presenting the implications of uncertainty in a CEA to decision makers. Although it is argued that the interpretation of such curves as the probability that an intervention is cost-effective given the data requires a Bayesian approach, this should generate no misgivings for the frequentist. Furthermore, cost-effectiveness acceptability curves estimated using the net benefit statistic are exactly equivalent to those estimated from an appropriate analysis of ICERs on the cost-effectiveness plane. The principles examined in this paper are illustrated by application to the cost-effectiveness of blood pressure control in the U.K. Prospective Diabetes Study (UKPDS 40). Due to a lack of good-quality prior information on the cost and effectiveness of blood pressure control in diabetes, a Bayesian analysis assuming an uninformative prior is argued to be most appropriate. This generates exactly the same cost-effectiveness results as a standard frequentist analysis.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Briggs, Professor Andrew
Authors: Briggs, A.
Subjects:R Medicine > RA Public aspects of medicine
Q Science > QA Mathematics
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences
Journal Name:International Journal of Technology Assessment in Health Care
Publisher:Cambridge University Press
ISSN:0266-4623
Copyright Holders:Copyright © 2001 Cambridge University Press
First Published:First published in International Journal of Technology Assessment in Health Care 17(1):69-82
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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