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Interpreting cost analyses of clinical interventions
E A Balas1, R A Kretschmer, W Gnann
1School of Medicine, University of Missouri, Columbia 65211, USA.
JAMA
|January 10, 1998
Summary
Physicians need cost data for interventions. Many clinical trials report costs but omit crucial details like start-up expenses and overhead, hindering economic analysis. A standardized protocol can improve cost reporting in healthcare.
Area of Science:
- Health Economics
- Clinical Trial Analysis
- Healthcare Management
Background:
- Physicians require reliable economic data for healthcare interventions amid cost containment pressures.
- Interpreting economic analyses and estimating implementation costs are crucial for practitioners.
- Existing literature often lacks comprehensive cost data in clinical trial reports.
Purpose of the Study:
- To assess the reporting of cost data in clinical trials.
- To identify common omissions in cost calculations within published research.
- To provide a framework for practitioners to better estimate intervention costs.
Main Methods:
- Conducted a MEDLINE search from 1966 to 1995 for articles on medical costs.
- Applied eligibility criteria including random assignment, quality improvement interventions, measured effects, and cost calculation.
- Utilized a costing protocol for independent data abstraction and consensus development.
Main Results:
- Over half of the reviewed articles (53.6%) included actual cost data.
- Operating expenses (direct cost, labor, supplies) were most frequently reported.
- General overhead (93.8%) and start-up costs (85.6%) were frequently omitted.
Conclusions:
- Clinical trial reports often make cost claims without sufficient supporting data.
- Start-up costs and general overhead are commonly missing from expenditure data in trials.
- A standardized costing protocol can enhance the accuracy and completeness of cost reporting in healthcare research.