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National Healthcare Economic Evaluation Guidelines: A Cross-Country Comparison

Author

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  • Deepshikha Sharma

    (Post Graduate Institute of Medical Education and Research)

  • Arun Kumar Aggarwal

    (Post Graduate Institute of Medical Education and Research)

  • Laura E. Downey

    (Imperial College)

  • Shankar Prinja

    (Post Graduate Institute of Medical Education and Research)

Abstract

Background and Objectives Globally, a number of countries have developed guidelines that describe the design and conduct of economic evaluations as part of health technology assessment (HTA) or pharmacoeconomic analysis for decision making. The current scoping review was undertaken with an objective to summarize the recommendations made on methods of economic evaluation by the national healthcare economic evaluation (HEE) guidelines. Methodology A comprehensive search was undertaken in the website repositories of the International Society for Pharmacoeconomic and Outcomes Research (ISPOR) and Guide to Economic Analysis and Research (GEAR), and websites of national HTA agencies and ministries of health of individual countries. All guidelines in the English language were included in this review. Data were extracted with respect to general and methodological characteristics, and a descriptive analysis of recommendations made across the countries was undertaken. Results Overall, our review included 31 national HEE guidelines, published between 1997 and August 2020. Nearly half (45%) of the guidelines targeted the evaluation of pharmaceuticals. The nature of the guidelines was either mandatory (31%), recommendatory (42%), or voluntary (16%). There was a substantial consensus among the guidelines on several key principles, including type of economic evaluation (cost-utility analysis), time horizon of the analysis (long enough), health outcome measure (quality-adjusted life-years) and use of sensitivity analyses. The recommendations on study perspective, comparator, discount rate and type of costs to be included (particularly the inclusion of indirect costs) varied widely. Conclusion Despite similarity in the overall processes, variation in several recommendations given by various national HEE guidelines was observed. This is perhaps unsurprising given the differences in the health systems and financing mechanisms, capacity of local researchers, and data availability. This review offers important lessons and a starting point for countries that are planning to develop their own HEE guidelines.

Suggested Citation

  • Deepshikha Sharma & Arun Kumar Aggarwal & Laura E. Downey & Shankar Prinja, 2021. "National Healthcare Economic Evaluation Guidelines: A Cross-Country Comparison," PharmacoEconomics - Open, Springer, vol. 5(3), pages 349-364, September.
  • Handle: RePEc:spr:pharmo:v:5:y:2021:i:3:d:10.1007_s41669-020-00250-7
    DOI: 10.1007/s41669-020-00250-7
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    References listed on IDEAS

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    1. Shankar Prinja & Akashdeep Chauhan & Blake Angell & Indrani Gupta & Stephen Jan, 2015. "A Systematic Review of the State of Economic Evaluation for Health Care in India," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 595-613, December.
    2. Kobelt, G., 2013. "Health Economics: An Introduction to Economic Evaluation," Monographs, Office of Health Economics, number 000004.
    3. Julio López-Bastida & Juan Oliva & Fernando Antoñanzas & Anna García-Altés & Ramón Gisbert & Javier Mar & Jaume Puig-Junoy, 2010. "Spanish recommendations on economic evaluation of health technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 513-520, October.
    4. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
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