Estimating cost-effectiveness from claims and registry data with measured and unmeasured confounders.

ABSTRACT: The analysis of observational data to determine the cost-effectiveness of medical treatments is complicated by the need to account for skewness, censoring, and the effects of measured and unmeasured confounders. We quantify cost-effectiveness as the Net Monetary Benefit (NMB), a linear combination of the treatment effects on cost and effectiveness that denominates utility in monetary terms. We propose a parametric estimation approach that describes cost with a Gamma generalized linear model and survival time (the canonical effectiveness variable) with a Weibull accelerated failure time model. To account for correlation between cost and survival, we propose a bootstrap procedure to compute confidence intervals for NMB. To examine sensitivity to unmeasured confounders, we derive simple appro

SUBMITTER: Handorf EA 

PROVIDER: S-EPMC7673459 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature