Feasibility of using administrative claims data for cost-effectiveness analysis of a clinical trial

Abstract

Objective-This study was performed retrospectively to determine if Medicare claims data could be used to evaluate the cost-effectiveness, from a payer perspective, of different radiation treatment schedules evaluated in a national clinical trial.Methods-Medicare costs from all providers and all places of service were obtained from the Centers for Medicare & Medicaid Services (CMS) for patients treated from 1992-1996 on Radiation Therapy Oncology Group (RTOG) 90-03, and combined with data on outcomes from the trial.Results-Of the 1113 patients entered, Medicare cost data and clinical outcomes were available for 187 patients. Significant differences in tolerance of treatment and outcome were noted between patients with Medicare data included in the study and patients without Medicare data and nonMedicare patients excluded form it. Ninety-five percent confidence ellipses on the incremental costeffectiveness scatterplots crossed both axes, indicating non-significant differences in costeffectiveness between radiation treatment schedules.Conclusions-Claims data permit estimation of cost-effectiveness, but Medicare data provide inadequate representation of results applicable to patients from the general population.

An economic analysis of Radiation Therapy Oncology Group 94-10: cost-efficacy of concurrent vs. sequential chemoradiotherapy

“…We have previously published our methods for determining costs utilizing Medicare data 7,8 . Exclusion criteria for this analysis included patients having no RTOG follow-up, patients lacking a Medicare match, patients enrolled in a Medicare HMO, patients entering the trial after January 1997 as they would have little data within the current analysis period, and those for whom we had no claims at all after they entered the trial.…”