An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis
Introduction Economic analyses of well-conducted clinical trials are critical to rational health policy that informs value-based decision making. Trial economic analyses, such as cost-effectiveness analysis, often rely on trial-collected data, which are burdensome and expensive to collect. In contra...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Swansea University
2020-12-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/1431 |
| _version_ | 1797430717095870464 |
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| author | Timothy P Hanna Paul Nguyen Joe Pater Christopher J O’Callaghan Nicole Mittmann Craig C Earle Dongsheng Tu Derek Jonker Annette Hay |
| author_facet | Timothy P Hanna Paul Nguyen Joe Pater Christopher J O’Callaghan Nicole Mittmann Craig C Earle Dongsheng Tu Derek Jonker Annette Hay |
| author_sort | Timothy P Hanna |
| collection | DOAJ |
| description | Introduction
Economic analyses of well-conducted clinical trials are critical to rational health policy that informs value-based decision making. Trial economic analyses, such as cost-effectiveness analysis, often rely on trial-collected data, which are burdensome and expensive to collect. In contrast, administrative databases systematically collect health system encounters and are available at low cost for nearly all patients with cancer in Ontario, Canada, and many other jurisdictions.
Objectives and Approach
We investigated whether administrative data could improve the performance of trial economic analysis. Health administrative data were probabilistically linked to 148 Ontario patients from the Canadian Cancer Trials Group CO.17 trial (n=572), which evaluated cetuximab plus best supportive care (n=75) versus best supportive care alone (n=73) in previously treated metastatic colorectal cancer. Trial-collected resource utilization data and vital status were compared with administrative data. Cost-effectiveness in 2007 Canadian dollars according to administrative data was determined with bootstrap incremental cost-effectiveness ratio (ICER) confidence intervals (CIs).
Results
Up to trial date of last contact, administrative data vital status was concordant in >96%. Twenty-nine subsequent deaths occurred. Up to trial last contact, there were 50 net additional hospitalizations and 33 net additional emergency department visits in administrative data. Total costs were $3,023,034 for the cetuximab group and $1,191,118 for the control group up to trial last contact. ICER was $211,128 per life-year gained (90% CI: $101,396 to $694,950) up to trial last contact and $164,378 (90% CI: -$138,260 to $644,555) up to administrative data last contact. ICER estimates were similar to analyses using trial-collected data.
Conclusion/Implications
Administrative data were more complete than trial data for hospital encounters, a key cost driver in economic analysis and there was longer follow-up. This study demonstrates the potential of administrative data to relieve the burden of collecting key data in cancer trials, which represents considerable effort and expense. |
| first_indexed | 2024-03-09T09:32:33Z |
| format | Article |
| id | doaj.art-13ab935e396d48d295469a0702242ebf |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T09:32:33Z |
| publishDate | 2020-12-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-13ab935e396d48d295469a0702242ebf2023-12-02T03:15:14ZengSwansea UniversityInternational Journal of Population Data Science2399-49082020-12-015510.23889/ijpds.v5i5.1431An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic AnalysisTimothy P Hanna0Paul Nguyen1Joe Pater2Christopher J O’Callaghan3Nicole Mittmann4Craig C Earle5Dongsheng Tu6Derek Jonker7Annette Hay8Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, 10 Stuart Street, 2nd Level, Kingston ON K7L3N6 CanadaICES at Queen's University, 21 Arch Street, Kingston ON K7L3L4 CanadaCanadian Cancer Trials Group, Queen’s University, 10 Stuart Street, Kingston, ON K7L3N6 CanadaCanadian Cancer Trials Group, Queen’s University, 10 Stuart Street, Kingston, ON K7L3N6 CanadaCanadian Agency for Drugs and Technologies in Health, 865 Carling Avenue, Ottawa, ON K1S5S8 CanadaFaculty of Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON M5S1A8 CanadaCanadian Cancer Trials Group, Queen’s University, 10 Stuart Street, Kingston, ON K7L3N6 CanadaDepartment of Internal Medicine, Division of Medical Oncology, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H8L6 CanadaCanadian Cancer Trials Group, Queen’s University, 10 Stuart Street, Kingston, ON K7L3N6 CanadaIntroduction Economic analyses of well-conducted clinical trials are critical to rational health policy that informs value-based decision making. Trial economic analyses, such as cost-effectiveness analysis, often rely on trial-collected data, which are burdensome and expensive to collect. In contrast, administrative databases systematically collect health system encounters and are available at low cost for nearly all patients with cancer in Ontario, Canada, and many other jurisdictions. Objectives and Approach We investigated whether administrative data could improve the performance of trial economic analysis. Health administrative data were probabilistically linked to 148 Ontario patients from the Canadian Cancer Trials Group CO.17 trial (n=572), which evaluated cetuximab plus best supportive care (n=75) versus best supportive care alone (n=73) in previously treated metastatic colorectal cancer. Trial-collected resource utilization data and vital status were compared with administrative data. Cost-effectiveness in 2007 Canadian dollars according to administrative data was determined with bootstrap incremental cost-effectiveness ratio (ICER) confidence intervals (CIs). Results Up to trial date of last contact, administrative data vital status was concordant in >96%. Twenty-nine subsequent deaths occurred. Up to trial last contact, there were 50 net additional hospitalizations and 33 net additional emergency department visits in administrative data. Total costs were $3,023,034 for the cetuximab group and $1,191,118 for the control group up to trial last contact. ICER was $211,128 per life-year gained (90% CI: $101,396 to $694,950) up to trial last contact and $164,378 (90% CI: -$138,260 to $644,555) up to administrative data last contact. ICER estimates were similar to analyses using trial-collected data. Conclusion/Implications Administrative data were more complete than trial data for hospital encounters, a key cost driver in economic analysis and there was longer follow-up. This study demonstrates the potential of administrative data to relieve the burden of collecting key data in cancer trials, which represents considerable effort and expense.https://ijpds.org/article/view/1431 |
| spellingShingle | Timothy P Hanna Paul Nguyen Joe Pater Christopher J O’Callaghan Nicole Mittmann Craig C Earle Dongsheng Tu Derek Jonker Annette Hay An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis International Journal of Population Data Science |
| title | An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis |
| title_full | An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis |
| title_fullStr | An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis |
| title_full_unstemmed | An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis |
| title_short | An Evaluation of Linked Administrative Data for Cancer Clinical Trial Economic Analysis |
| title_sort | evaluation of linked administrative data for cancer clinical trial economic analysis |
| url | https://ijpds.org/article/view/1431 |
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