Journal
STATISTICS IN MEDICINE
Volume 22, Issue 12, Pages 1955-1976Publisher
WILEY
DOI: 10.1002/sim.1389
Keywords
multinational clinical trials; interaction; cost-effectiveness; net health benefits
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Because of the potential for large variability among countries in the utilization and cost of health care resources, it is important to assess the appropriateness of combining economic data across the countries in a multinational clinical economic trial. We show how available tests for interaction can be applied to economic endpoints, including cost-effectiveness ratios and net health benefits. This analysis includes a characterization of possible interactions being quantitative or qualitative in nature. In the absence of interaction, a pooled estimate of the economic endpoint should be representative of the participating countries. We explore the analytic issues by further analysing data from the Scandinavian Simvastatin Survival Study (4S). Copyright (C) 2003 John Wiley Sons, Ltd.
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