Sample size calculation in economic evaluations
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Updated: Oct 29, 2026

Measuring Delay Discounting in Humans Using an Adjusting Amount Task
Published on: January 9, 2016
M J Al1, B A van Hout, B C Michel
1Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands. al@econ.bmg.eur.nl
Abstract:
A simulation method is presented for sample size calculation in economic evaluations. As input the method requires: the expected difference and variance of costs and effects, their correlation, the significance level (alpha) and the power of the testing method and the maximum acceptable ratio of incremental effectiveness to incremental costs. The method is illustrated with data from two trials. The first compares primary coronary angioplasty with streptokinase in the treatment of acute myocardial infarction, in the second trial, lansoprazole is compared with omeprazole in the treatment of reflux oesophagitis. These case studies show how the various parameters influence the sample size. Given the large number of parameters that have to be specified in advance, the lack of knowledge about costs and their standard deviation, and the difficulty of specifying the maximum acceptable ratio of incremental effectiveness to incremental costs, the conclusion of the study is that from a technical point of view it is possible to perform a sample size calculation for an economic evaluation, but one should wonder how useful it is.
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