Average cost-effectiveness ratio with censored data

J Biopharm Stat. 2012;22(2):401-15. doi: 10.1080/10543406.2010.544437.


In cost-effectiveness analysis, interest could lie foremost in the incremental cost-effectiveness ratio (ICER), which is the ratio of the incremental cost to the incremental benefit of two competing interventions. The average cost-effectiveness ratio (ACER) is the ratio of the cost to benefit of an intervention without reference to a comparator. A vast literature is available for statistical inference of the ICERs, but limited methods have been developed for the ACERs, particularly in the presence of censoring. Censoring is a common feature in prospective studies, and valid analyses should properly adjust for censoring in cost as well as in effectiveness. In this article, we propose statistical methods for constructing a confidence interval for the ACER from censored data. Different methods-Fieller, Taylor, bootstrap-are proposed, and through simulation studies and data analysis, we address the performance characteristics of these methods.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms
  • Computer Simulation
  • Confidence Intervals
  • Cost-Benefit Analysis / statistics & numerical data*
  • Humans
  • Models, Statistical*
  • Prospective Studies