Trial-based economic evaluations are effective vehicles for generating unbiased economic evidence on the cost-effectiveness of healthcare interventions. High-quality economic evaluation alongside clinical studies is desirable because they, can provide timely and unbiased evidence with high internal and external validity. However, there are methodological challenges to trial-based evaluations, which include identifying relevant comparators and time horizon for economic evaluation, collection of reliable data on resources use and cost, choice of appropriate health outcome measures for economic analysis, dealing with missing economic data, and extrapolating outcomes and costs over lifetime horizon. This lecture highlights some of the issues and challenges of trial-based economic evaluations, using two large clinical trials in the UK - ProMISe* and CALORIES** - as case studies. The discussion will emphasize the importance of integrated economic evaluation alongside clinical studies, robust design, selection of instruments and methods to estimate resource utilization and health outcomes, use of recommended multiple imputation methods for imputing missing economic data, plausible approaches for extrapolating within trial estimates over lifetime, and analysis principles for health economic endpoints to help improve resource allocation decision making. In conclusion, some of the key challenges and lessons from conducting economic evaluation alongside large pragmatic trials in the UK will be highlighted, with reference to wider healthcare settings.
: Seminar will be live-streamed, allowing for online audience participation (only available during the seminar)