Measuring costs in multisite randomized controlled trials: lessons from the VA Cooperative Studies Program

Area of Science:

• Health Economics
• Clinical Trial Analysis
• Health Services Research

Background:

• Growing interest in the economic impact of novel healthcare interventions.
• Variability in economic impact assessments due to differing assumptions and methodologies.
• Need for standardized approaches to measure healthcare costs in clinical studies.

Purpose of the Study:

• To describe experiences and strategies for measuring healthcare utilization and costs within the VA Cooperative Studies Program.
• To illustrate methods for economic data collection in multisite randomized clinical trials (RCTs).
• To inform health planning and policy by providing evidence on the cost of healthcare innovations.

Main Methods:

• Direct measurement of healthcare utilization within two multisite RCTs.
• Collection of economic data concurrently with clinical intervention evaluation.
• Application of accepted health economic approaches in data collection and analysis.

Main Results:

• Direct measurement of healthcare utilization provides valuable cost data for clinical interventions.
• Experiences highlight the feasibility of integrating economic assessments into RCTs.
• Substantial resources are necessary for comprehensive cost-of-care evidence generation.

Conclusions:

• Future VA multisite studies should incorporate standardized health economic methodologies.
• Accurate cost data collection is crucial for effective health planning and policy development.
• Evidence on the cost of healthcare innovations is vital for both internal and external healthcare systems.