Switching Therapy in Health Economics Trials: Confronting the Confusion Journal Articles

abstract

• Should patients in a randomized, pragmatic health economics trial be allowed to switch therapy in mid-trial to that pro- vided in the other arm? Specifically, should patients in the treatment arm (T) be allowed to switch to the therapy of the comparator arm (C) if they need a change of therapy—that is, should TC switches be allowed? Also, should patients in the comparator arm be allowed to switch to the therapy of the treatment arm if they need changes of therapy—should CT switches be allowed? This is a nontrivial issue in study design that has been debated in the clinical trials literature and is currently being handled inconsistently in the health economics literature. In this article, the authors argue that TC switches should always be allowed and that CT switches should be allowed or not depending on the economic question. They further argue that the most common economic question is one that would lead to CT switches not being al- lowed.

authors

• Torrance, George Walter
• Drummond, Michael F
• Walker, Valery

status

• published 

publication date

• July 2003

has subject area

• 1117 Public Health and Health Services (FoR)
• 1402 Applied Economics (FoR)
• Canada (MeSH)
• Cost-Benefit Analysis (MeSH)
• Cross-Over Studies (MeSH)
• Drug Evaluation (MeSH)
• Health Policy & Services (Science Metrix)
• Humans (MeSH)
• Patient Selection (MeSH)
• Randomized Controlled Trials as Topic (MeSH)
• Therapeutic Human Experimentation (MeSH)

published in

• Medical decision making  Journal

keywords

• Canada
• Cost-Benefit Analysis
• Cross-Over Studies
• Drug Evaluation
• Humans
• Patient Selection
• Randomized Controlled Trials as Topic
• Therapeutic Human Experimentation

Digital Object Identifier (DOI)

• 10.1177/0272989x03256007

PubMed ID

• 12926583

start page

• 335

end page

• 340

volume

• 23

issue

• 4