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[Potential sponsorship bias in cost-effectiveness analyses of healthcare interventions: A cross-sectional analysis]
Ferrán Catalá-López1, Manuel Ridao2
1Departamento de Medicina, Universidad de Valencia/Instituto de Investigación Sanitaria INCLIVA y CIBERSAM, Valencia, España; Fundación Instituto de Investigación en Servicios de Salud, Valencia, España; Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canadá.
Objective:
To examine the relationship between the funding source of cost-effectiveness analyses of healthcare interventions published in Spain and study conclusions.
Design:
Descriptive cross-sectional study.
Location:
Scientific literature databases (until December 2014).
Participants (Analysis Units):
Cohort of cost-effectiveness analysis of healthcare interventions published in Spain between 1989-2014 (n=223) presenting quality-adjusted life years (QALYs) as the outcome measure.
Main Measurements:
The relationship between qualitative conclusions of the studies and the type of funding source were established using Fisher's exact test in contingency tables. Distributions of the incremental cost-effectiveness ratios by source of funding in relation to hypothetical willingness to pay thresholds between €30,000-€50,000 per QALY were explored.
Results:
A total of 136 (61.0%) studies were funded by industry. The industry-funded studies were less likely to report unfavorable or neutral conclusions than studies non-funded by industry (2.2% vs. 23.0%; P<.0001), largely driven by studies evaluating drugs (0.9% vs. 21.4%; P<.0001). The incremental cost-effectiveness ratios in studies funded by industry were more likely to be below the hypothetical willingness to pay threshold of €30,000 (73.8% vs. 56.3%; P<.0001) and €50,000 (89.4% vs. 68.2%; P<.0001) per QALY.
Conclusions:
This study reveals a potential sponsorship bias in cost-effectiveness analyses of healthcare interventions. Studies funded by industry could be favoring the efficiency profile of their products.
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