Developments in Economic Evaluation in Health Care: A Review of HEED

Health care decision makers are becoming increasingly concerned with obtaining value for money and therefore with the use of economic evidence, particularly as a criterion for the reimbursement of new pharmaceuticals. There are a range of countries in which economic considerations have been introduced into the decision making process together with some of the associated policy applications. As the application of economic criteria has become more widespread, so sources of information on the cost-effectiveness of health care technologies have acquired a greater level of importance. One such source is HEED – the Health Economic Evaluations Database, which has contributed to the evidence base called upon in around a quarter of the first 75 technology appraisals completed by the National Institute for Clinical Excellence (NICE). In this context, HEED and NHS EED provide complementary sources of evidence to clinical databases such as Medline and Embase. The burgeoning demand for economic evidence suggests that established databases such as HEED and NHS EED will have a greater part to play in assembling the economic evidence base on which decisions are being made and will increasingly be made in future. The objective of this briefing is to set out the types of studies included on HEED and to present an analysis of how these studies have changed over time, in terms of broad characteristics such as types of evaluation, disease areas covered and study design.