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The Challenges of Economic Evaluation Alongside Large Clinical Trials: The UK Experience

October 31, 2019

Kuala Lumpur World Bank-University of Malaya Joint Seminar

  • 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.

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  • Zia Sadique is an Assistant professor in Health Economics at the London School of Hygiene & Tropical Medicine (LSHTM).  He received his training in economics at the Australian National University, City University (London) and the London School of Economics. Before joining LSTMH, he has worked for the UK government’s 'Public Health England'. His research involves economic evaluation of health interventions using large clinical trials and observational data and analysis of choice experiments to quantify preferences for health and health care. More recent work focuses on the economics of cancer control and cost-effectiveness analysis of interventions in humanitarian crisis. He has received research funding from different national and international agencies such as NIHR, MRC/DfID/Wellcome Trust, GCRF/ESRC, EDCTP/EU. Dr Sadique has over 40 peer reviewed publications in journals such as the New England Journal of Medicine, Journal of the American Medical Association, Health Economics, Value in Health, European Journal of Health Economics and so on. 


  • WHEN: Thursday, October 31, 2019; 12:30 -2:00PM
  • WHERE: World Bank Malaysia Office, Level 3, Sasana Kijang, No. 2, Jalan Dato’ Onn
  • RSVP: Kindly RSVP by Wednesday, October 30, 2019