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Qualitative comparative analysis of health economic evaluation guidelines for health technology assessment in European countries

Published online by Cambridge University Press:  10 December 2020

Konstantinos Zisis Open the ORCID record for Konstantinos Zisis [Opens in a new window] ,
Panagiota Naoum  and
Kostas Athanasakis
Konstantinos Zisis
Affiliation:
Institute for Health Economics, Athens11521, Greece
Panagiota Naoum
Affiliation:
Institute for Health Economics, Athens11521, Greece
Kostas Athanasakis
Affiliation:
Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
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Abstract

Objective

To classify, analyze, and compare published guidelines for economic evaluation within health technology assessment (HTA) in European countries and highlight differences and similarities.

Methods

We performed a literature review to identify published guidance for the conduct and assessment of economic evaluation studies that are undertaken within the context of HTA processes in European countries. Organizations and working groups were identified via the ISPOR, INAHTA, and EUnetHTA databases. Following the identification of official documents, we performed a qualitative content analysis to highlight discrepancies or common practices under the following categories: comparator, perspective on costs/benefits, time horizon, economic evaluation method, instrument used for utility measurement, outcome measure, source for efficacy, modeling, sensitivity analysis, discounting, and incremental cost-effectiveness ratio.

Results

A total of nineteen guidance documents were identified (in English) providing data for the analysis in nineteen countries. The comparative content analysis identified common practices in most countries regarding the approaches to the choice of comparator, source of data, the preferred economic evaluation method, the option for a lifetime analytical horizon, discounting, and the choice of key outcome measure—for which, most countries recommend the use of the EQ-5D instrument. Differences were mainly found in the choice of perspective, dealing with uncertainty and sensitivity analysis, the use of end points, and the required use of modeling.

Conclusions

The use of economic evaluation constitutes one of the key pillars of the HTA process in Europe. Although a methodological convergence has occurred during the last few years, notable differences still remain.

Keywords

Economic evaluationGuidelinesHealth technology assessmentEuropean Union
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 37 , Issue 1 , 2021 , e2
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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