Reviewing Evidence For Use In Cost Effectiveness Models

Sheffield, United Kingdom – Health technology assessments typically require the development of a cost-effectiveness model which necessitates the identification, selection and use of other types of information beyond clinical effectiveness evidence in order to populate the model parameters. The reviewing activity associated with model development should be transparent and reproducible but can result in a tension between being both timely and systematic. Little procedural guidance existed in this area, until now.

Researchers from the School of Health and Related Research at the University of Sheffield have developed guidance, informed by focus groups, on what might constitute a systematic and transparent approach to reviewing information to populate model parameters.

Seven key themes were identified in this research including: selection and prioritisation of data to inform parameter estimates; reviewing methods; minimising bias, hierarchies of evidence; study selection; assessment of evidence and synthesis and analysis. The participants in in the focus groups considered these to be important areas where guidance would be particularly useful.

Recommendations from this research included the use of rapid reviewing methods and the need to consider the trade-off between relevance and quality. Transparency in the reporting of review methods was emphasized. In addition, attention should be given to the reporting of parameters deemed to be more important to the model or where the preferred decision regarding the choice of evidence is equivocal.

“The issues raised in this research are important in the field of HTA. The principles of evidence-based medicine lie at the heart of HTA; therefore questions regarding the identification and selection of evidence have an influence on the structure and conclusions of the cost-effectiveness model and subsequent decision making.” said Eva Kaltenthaler, PhD, Reader in Health Technology Assessment, ScHARR, University of Sheffield. The full study, “Reviewing the Evidence to Inform the Population of Cost-Effectiveness Models within Health Technology Assessments,” is published in Value in Health.

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.

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