RESOURCE COSTING FOR MULTINATIONAL NEUROLOGIC CLINICAL-TRIALS - METHODS AND RESULTS

We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treat ment of subarachnoid hemorrhage within a clinical trial. The study des cribes a framework for the collection and analysis of international re source cost data that can contribute to a consistent and accurate inte rcountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following sev en: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggr egated the data to develop study unit costs. When unit costs were unav ailable, we developed an index table, based on a market-basket approac h, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavail able in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based r elative value units. Finally, we converted study unit costs to a commo n currency using purchasing power parity measures. Through this castin g exercise we developed a set of unit costs for patient services and p er diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effe ctive multinational costing exercises. (C) 1998 John Wiley & Sons, Ltd .