Industry sponsorship bias in cost effectiveness analysis: registry based analysis

Abstract

Objective To assess the association between industry sponsorship (drug, medical device, and biotechnology companies) and cost effectiveness results in cost effectiveness analysis (CEA). Design Registry based analysis Data source The Tufts Cost-Effectiveness Analysis Registry was used to identify all CEAs published in Medline between 1976 and 2021. Eligibility criteria for selecting studies CEAs that reported incremental cost effectiveness ratio (ICER) using quality adjusted life year and provided sufficient information about the magnitude or location of the ICER. Methods Descriptive analyses were used to describe and compare the characteristics of CEAs with and without industry sponsorship. Logistic regression was used to identify the association between industry sponsorship and the cost effective conclusion using selected threshold values ($50 000 (£40 511; €47 405), $100 000, and $150 000). Robust linear regression was used to assess the association between industry sponsorship and the magnitude of ICER. All regression analyses were adjusted for disease and study design characteristics. Results 8192 CEAs were eligible and included in the analysis, with 2437 (29.7%) sponsored by industry. Industry sponsored CEAs were more likely to publish ICERs below $50 000 (adjusted odds ratio 2.06, 95% confidence interval 1.82 to 2.33), $100 000 (2.95, 2.52 to 3.44), and $150 000 (3.34, 2.80 to 3.99) than non-industry sponsored studies. Among 5877 CEAs that reported positive incremental costs and quality adjusted life years, ICERs from industry sponsored studies were 33% lower (95% confidence interval −40 to −26) than those from non-industry sponsored studies. Conclusions Sponsorship bias in CEAs is significant, systemic, and present across a range of diseases and study designs. Use of CEAs conducted by independent bodies could provide payers with more ability to negotiate lower prices. This impartiality is especially important for countries that rely on published CEAs to inform policy making for insurance coverage because of limited capacity for independent economic analysis.

Facilitating bias in cost-effectiveness analysis: CHEERS 2022 and the creation of assumption-driven imaginary value claims in health technology assessment

“…A recent evaluation presented in the BMJ , makes the claim that, in the universe of modeled cost-effectiveness claims, bias is pervasive in industry-sponsored studies. 5 This is, of course, an unexceptional conclusion as there is a wealth of evidence to support claims for bias where industry-funded cost-effectiveness claims are likely to report favorable results to the sponsor are readily published in leading journals. 6 , 7 , 8 , 9 The focus of the BMJ study is the Tufts University Cost-Effectiveness Analysis (CEA) Registry and the reporting of claims for studies published between 1976 and 2021; the majority in the last 10 years.…”

Values and Preferences of Patients and Caregivers Regarding Treatment of Atopic Dermatitis (Eczema)

“…An understanding of patient values and preferences toward bleach baths, allergen immunotherapy, dietary elimination, and systemic therapies are necessary to inform optimal clinical decision-making . With recent data showing the pervasive and influential nature of industry sponsorship bias in cost-effectiveness analyses, our finding of 18 studies being sponsored by industry (and often conducted and written by them), shows the critical need for robust and independent analyses of patient values and preferences regarding new AD treatments. While we included studies examining all severities of AD, future studies should clearly report whether patient values and preferences are affected by AD severity.…”

Evidencia científica y gestión del conocimiento

“…Esta limitación también la agravan los sesgos de publicación (y de patrocinio) que pueden darse en las evaluaciones económicas de intervenciones sanitarias [41][42][43] . Por ejemplo, parece que es más…”