Pharmacoeconomic Guidelines Unclear On Dealing With Patient Differences

Maastricht, The Netherlands – Acknowledging patient heterogeneity in economic evaluations and subsequent reimbursement decisions may lead to more effective and/or efficient health care. Despite this potential gain, patient heterogeneity is still frequently neglected in economic evaluations.

National pharmacoeconomic guidelines, which provide guidance on performing economic evaluations, should stimulate and facilitate the acknowledgement of patient heterogeneity by providing specific guidance on acknowledging patient heterogeneity. The checklist presented in the paper, “How Should We Deal with Patient Heterogeneity in Economic Evaluation: A Systematic Review of National Pharmacoeconomic Guidelines,” published in Value in Health, can assist in formulating this guidance.

Bram Ramaekers, Manuela Joore (both from Maastricht University Medical Centre) and Janneke Grutters (Radboud University Nijmegen Medical Centre) systematically reviewed and analyzed recommendations from national pharmacoeconomic guidelines with regard to acknowledging patient heterogeneity in economic evaluations.

They found that the majority of national pharmacoeconomic guidelines provide general guidance on acknowledging patient heterogeneity in economic evaluations. However, its usefulness is limited since this guidance is mostly not specific.

“Acknowledging patient heterogeneity is considered as part of quality criteria for good practice in economic evaluations and general guidance on this topic is presented in most pharmacoeconomic guidelines. Thus, it seems that the importance of acknowledging patient heterogeneity is internationally recognized, while there is a lack of consensus on specific recommendations to acknowledge patient heterogeneity in economic evaluations.” states Bram Ramaekers. “Therefore, we advise the further development of pharmacoeconomic guidelines to provide specific guidance on acknowledging patient heterogeneity. This could facilitate the systematic and transparent handling of patient heterogeneity in economic evaluations worldwide.”


Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research as well as policy papers to help health care leaders make evidence-based decisions. The journal is published bi-monthly and has over 8,000 subscribers (clinicians, decision makers, and researchers worldwide).

International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.

For more information: www.ispor.org

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