Incremental net benefit in randomized clinical trials with quality-adjusted survival

Stat Med. 2003 Feb 15;22(3):353-62. doi: 10.1002/sim.1347.


Owing to induced dependent censoring, estimating mean costs and quality-adjusted survival in a cost-effectiveness comparison of two groups using standard life-table methods leads to biased results. In this paper we propose methods for estimating the difference in mean costs and the difference in mean effectiveness, together with their respective variances and covariance in the presence of dependent censoring. We consider the situation in which the measure of effectiveness is either the probability of surviving a duration of interest or mean quality-adjusted survival time over a duration of interest. The methods are illustrated in an example using an incremental net benefit analysis.

MeSH terms

  • Amiodarone / therapeutic use
  • Anti-Arrhythmia Agents / therapeutic use
  • Cost-Benefit Analysis
  • Health Care Costs
  • Heart Arrest / economics
  • Heart Arrest / prevention & control
  • Humans
  • Models, Statistical*
  • Quality-Adjusted Life Years*
  • Randomized Controlled Trials as Topic / economics
  • Randomized Controlled Trials as Topic / methods*
  • Survival Analysis*
  • Syncope / drug therapy
  • Tachycardia, Ventricular / drug therapy
  • Ventricular Fibrillation / drug therapy


  • Anti-Arrhythmia Agents
  • Amiodarone