Journal
HEALTH ECONOMICS
Volume 16, Issue 8, Pages 815-826Publisher
WILEY
DOI: 10.1002/hec.1198
Keywords
multilevel modelling; multinational studies; economic evaluation; exchangeability
Funding
- MRC [MC_U105260792, G106/1173] Funding Source: UKRI
- Medical Research Council [MC_U105260792, G106/1173] Funding Source: Medline
- Medical Research Council [MC_U105260792, G106/1173] Funding Source: researchfish
Ask authors/readers for more resources
Multilevel models (MLMs) have been recommended for estimating incremental net benefits (INBs) in multicentre cost-effectiveness analysis (CEA). However, these models have assumed that the INBs are exchangeable and that there is a common variance across all centres. This paper examines the plausibility of these assumptions by comparing various MLMs for estimating the mean INB in a multinational CEA. The results showed that the MLMs that assumed the INBs were exchangeable and had a common variance led to incorrect inferences. The MLMs that included covariates to allow for systematic differences across the centres, and estimated different variances in each centre, made more plausible assumptions, fitted the data better and led to more appropriate inferences. We conclude that the validity of assumptions underlying MLMs used in CEA need to be critically evaluated before reliable conclusions can be drawn. Copyright (C) 2006 John Wiley & Sons, Ltd.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available