Adaptive clinical trial designs allow changes to an on-going trial based on early examinations of the data. These designs are increasing in popularity, but it is currently unclear what impact they have on health economic analyses that aim to maximise the health gained for money spent. Additionally, opportunities are potentially being missed to incorporate health economic considerations into the design and analysis of adaptive trials.
In this webinar held on 22 November 2022, Laura Flight, Scientific Adviser in the Science Policy and Research team at the National Institute for Health and Care Excellence (NICE), UK provided an overview of the current use of health economics in the design and analysis of adaptive clinical trials, including the potential opportunities and barriers to this approach as highlighted by a range of stakeholders. She described how existing theory can be extended to the health economic context to 1) maintain an accurate economic evaluation following an adaptive trial and 2) incorporate value of information analysis at the design stage and during an adaptive design.
About the presenter:
Laura Flight is a Scientific Adviser in the Science Policy and Research team at the National Institute for Health and Care Excellence (NICE), UK. Previously she worked as a Research Fellow in Health Economics and Statistics at the School of Health and Related Research (ScHARR), University of Sheffield. Laura’s methodological research to date has focused on innovative approaches to the design and conduct of clinical trials with an emphasis on how novel statistical methods can be applied in practice.
Additional resources:
The use of health economics in the design and analysis of adaptive clinical trials – https://www.sciencedirect.com/science/article/pii/S1098301518363058
How can health economics be used in the design and analysis of adaptive clinical trials? A qualitative analysis – https://link.springer.com/article/10.1186/s13063-020-4137-2
Expected value of sample information to guide the design of group sequential clinical trials. Medical Decision Making – https://journals.sagepub.com/doi/full/10.1177/0272989X211045036
The use of health economics in the design and analysis of adaptive clinical trials – https://etheses.whiterose.ac.uk/27924/
EcoNomics of Adaptive Clinical Trials (links to pre-print papers provided on webpage) –https://www.sheffield.ac.uk/scharr/research/centres/ctru/enact
Costing Adaptive Trials – https://link.springer.com/article/10.1186/s12916-022-02445-7
Costs and staffing resource requirements for adaptive clinical trials: quantitative and qualitative results from the Costing Adaptive Trials project – https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02124-z
A Practical Adaptive & Novel Designs and Analysis (PANDA) toolkit – https://panda.shef.ac.uk/