Measuring costs in multisite randomized controlled trials - Lessons from the VA Cooperative Studies Program

OBJECTIVES. The interest in the economic impact of new health care interven tions has increased dramatically over recent years; however, the results ca n be highly variable depending upon the economic assumptions made and the a pproaches taken in collecting the data and in conducting the analyses. This paper describes experiences from the VA Cooperative Studies Program in mea suring health care utilization and costs for studies that evaluate clinical interventions. METHODS. Experiences from two multisite randomized clinical trials (RCTs) a re highlighted to illustrate strategies used to measure costs by directly m easuring health care utilization and economic data within the context of th e trials, CONCLUSIONS. Despite the substantial resources required to gather evidence about the cost of care for health care innovations, future VA multisite stu dies should include accepted health economic approaches to make important c ontributions to health planning and health policy within and outside the VA health care system.