The data are from two arms of a double-blind clinical trial in which 91 patients were randomized to the SNRI duloxetine 80 mg/d (40 mg BID) and 87 patients were randomized to the SSRI paroxetine 20 mg/d for treatment of major depressive disorder (MDD). Missing-data- imputation and sensitivity-analyses were needed to make meaningful cost-effectiveness comparisons in this study.
A data frame of 3 variables on 178 patients; no NAs.
This measure of overall effectiveness is integrated decrease in HAMD-17 score from baseline to endpoint, Hamilton (1967). This is a (signed) area-under-the-curve measure with larger values more favorable. Missing values were imputed via the MMRM models reported in Goldstein et al. (2004).
Patient self-reported health-care resource utilization above and beyond that provided within study protocol was collected using the Resource Utilization Survey, Copley-Merriman et al. (1992), with published 1998 dollars-per-unit costs, Schoenbaum et al. (2001), rounded to the nearest 50 dollars. Dollars/week were then calculated by multiplying (total accumulated cost) for a patient by 7 and dividing by the (total days of cost accumulation) for that patient. For patients who discontinued early, this is Average-Value-Carried-Forward imputation.
Treatment indicator variable. dulx = 1 implies receipt of duloxetine 80 mg/d (40 mg BID). dulx = 0 implies receipt of paroxetine 20 mg/d.
Copley-Merriman C, Egbuonu-Davis L, Kotsanos JG, Conforti P, Franson T, Gordon G. Clinical economics: a method for prospective health resource data collection. Pharmacoeconomics 1992; 1(5): 370–376.
Goldstein DJ, Lu Y, Detke MJ, Wiltse C, Mallincrodt C, Demitrack MA. Duloxetine in the treatment of depression - A double-blind, placebo-controlled comparison with paroxetine. J Clin Psychopharmacol 2004; 24: 389–399.
Hamilton M. Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 1967; 6: 278–296.
Obenchain RL, Robinson RL, Swindle RW. Cost-effectiveness inferences from bootstrap quadrant confidence levels: three degrees of dominance. J Biopharm Stat 2005; 15(3): 419–436.
Schoenbaum M, Unutzer J, Sherbourne C, Duan N, Rubenstein LV, Miranda J, Meredith LS, Carney MF, Wells K. Cost-effectiveness of practice-initiated quality improvement for depression: results of a randomized controlled trial. JAMA 2001; 286(11): 1325–1330.
Loading required package: lattice Incremental Cost-Effectiveness (ICE) Lambda Scaling Statistics Specified Value of Lambda = 1 Cost and Effe Differences are both expressed in cost units Effectiveness variable Name = idb Cost variable Name = ru Treatment factor Name = dulx New treatment level is = 1 and Standard level is = 0 Observed Treatment Diff = 6.152 Std. Error of Trtm Diff = 8.186 Observed Cost Difference = -2.899 Std. Error of Cost Diff = 3.096 Observed ICE Ratio = -0.471 Statistical Shadow Price = 0.378 Power-of-Ten Shadow Price= 1
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