Incorporation of future costs in health economic analysis publications: current situation and recommendations for the future

Abstract

Future costs are not usually included in economic evaluations. The aim of this study was to assess the extent of published economic analyses that incorporate future costs. A systematic review was conducted of economic analyses published from 2008 to 2013 in three general health economics journals: PharmacoEconomics, Value in Health and the European Journal of Health Economics. A total of 192 articles met the inclusion criteria, 94 of them (49.0%) incorporated future related medical costs, 9 (4.2%) also included future unrelated medical costs and none of them included future nonmedical costs. The percentage of articles including future costs increased from 2008 (30.8%) to 2013 (70.8%), and no differences were detected between the three journals. All relevant costs for the perspective considered should be included in economic evaluations, including related or unrelated, direct or indirect future costs. It is also advisable that pharmacoEconomic guidelines are adapted in this sense.

Keywords:

• economic analysis
• future costs
• health economic analysis
• publications

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Key issues

• There are three different types of future costs: future related medical costs, future unrelated medical costs and future nonmedical costs.

• There is currently some controversy about the inclusion or not of future costs in economic evaluations.

• While there is broad agreement on the inclusion of future related medical costs in economic analyses, there are discrepancies in the literature and guidelines about how to manage future unrelated medical costs and future nonmedical costs when performing economic evaluations.

• A systematic review has been performed from 2008 to 2013 in three general health economics journals: PharmacoEconomics, Value in Health and the European Journal of Health Economics to know the extent of published economic analyses that incorporated future costs and the kind of future costs that were included.

• It was found that 49% of all published economic evaluations incorporated related future medical costs, 4.2% also included future unrelated medical costs and none of them included future nonmedical costs.

• All relevant costs for the perspective selected should probably be included in economic evaluations including related or unrelated, direct or indirect future costs.