The difference in mean costs between a placebo and a drug treated group is used for the pharmacoeconomic evaluation of a new drug. The distribution of costs without treatment (null hypothesis) is determined through hospital records. The sampling properties are established by simulation. The results of the simulation allow determination of a break point of differences corresponding to a given level of significance. For power determination, using this break point, clinical hypotheses are used to generate the distribution of costs under treatment (alternative hypothesis).
Bouckaert, A., & Crott, R. (1997). The difference in mean costs as a pharmacoeconomic outcome variable: power considerations. Controlled Clinical Trials, 18(1), 58-64. https://doi.org/10.1016/S0197-2456(95)00258-8 (Original work published 1997)