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Related Experiment Videos

Sample size calculation in economic evaluations

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

Health Economics
|July 31, 1998
PubMed
Summary
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Calculating sample size for economic evaluations is technically possible using a simulation method. However, the complexity and uncertainty of input parameters raise questions about its practical usefulness.

Area of Science:

  • Health Economics
  • Biostatistics
  • Clinical Trial Design

Background:

  • Economic evaluations are crucial for healthcare decision-making.
  • Accurate sample size calculation is essential for the validity of economic evaluations.
  • Existing methods for sample size calculation in economic evaluations have limitations.

Purpose of the Study:

  • To present a simulation method for sample size calculation in economic evaluations.
  • To illustrate the method's application using real-world trial data.
  • To assess the influence of various parameters on sample size determination.

Main Methods:

  • A simulation approach was developed for sample size calculation.
  • Inputs include expected differences and variances of costs and effects, their correlation, significance level (alpha), power, and the incremental cost-effectiveness ratio (ICER) threshold.

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  • The method was applied to two case studies: angioplasty vs. streptokinase for myocardial infarction and lansoprazole vs. omeprazole for reflux oesophagitis.

    • Main Results:

    • The simulation method can technically calculate sample sizes for economic evaluations.
    • Case studies demonstrated how different parameters impact the required sample size.
    • Sensitivity analyses revealed the influence of cost variance and ICER thresholds.

    Conclusions:

    • While technically feasible, performing sample size calculations for economic evaluations presents significant challenges.
    • Difficulties in specifying input parameters, such as cost variances and ICER thresholds, limit the practical utility of the method.
    • Further research is needed to refine methods and improve the reliability of sample size calculations in economic evaluations.