COST-EFFECTIVENESS SCENARIO ANALYSIS FOR A PROPOSED TRIAL OF HORMONE REPLACEMENT THERAPY

Whereas evaluation of resource implications and quality of life are of ten incorporated into assessments of health technology, the decision t o undertake the assessment is still mostly driven by interests in the clinical outcomes alone. A systematic approach to evaluating expected returns to health technology assessment has not been readily taken up by research funders or assessors. This paper sets out a specific metho dology for ex ante evaluation or triage and-proposes a decision proced ure, using alternative outcome scenarios and the associated policy cha nges and costs and benefits, against a background of likely clinical p ractice in the absence of the assessment. The methodology is used to c onsider implications of a proposed major clinical trial to assess the long term costs and benefits of hormone replacement therapy. (C) 1997 Elsevier Science Ireland Ltd.